| Indio Surgery Center | |
|
46900 Monroe St Suite B201 Indio CA 92201-4827 | |
| (760) 396-5733 | |
| (760) 396-5723 |
| Full Name | Indio Surgery Center |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 46900 Monroe St, Indio, California |
| Authorized Official Name and Position | Lawrence R Church (PRESIDENT) |
| Authorized Official Contact | 7603965733 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Indio Surgery Center 46900 Monroe St Ste B201 Indio CA 92201-4827 Ph: (760) 396-5733 | Indio Surgery Center 46900 Monroe St Suite B201 Indio CA 92201-4827 Ph: (760) 396-5733 |
| NPI Number | 1609090968 |
|---|---|
| Provider Enumeration Date | 04/11/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609090968 | NPI | - | NPPES |
| G93862-01 | Other | CA | DENTICAL PROVIDER NUMBER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 20615 (California) | Primary |
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