Inner Brightness Dental Pratice | |
6165 Valley Springs Pkwy Suite E Riverside CA 92507-0963 | |
(951) 214-6585 | |
(951) 214-6589 |
Full Name | Inner Brightness Dental Pratice |
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Speciality | Clinic/Center |
Location | 6165 Valley Springs Pkwy, Riverside, California |
Authorized Official Name and Position | Sergio P Saucedo (DDS) |
Authorized Official Contact | 9512146585 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Inner Brightness Dental Pratice 6165 Valley Springs Pkwy Suite E Riverside CA 92507-0963 Ph: (951) 214-6585 | Inner Brightness Dental Pratice 6165 Valley Springs Pkwy Suite E Riverside CA 92507-0963 Ph: (951) 214-6585 |
NPI Number | 1124324561 |
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Provider Enumeration Date | 02/02/2011 |
Last Update Date | 02/02/2011 |
Medicare PECOS PAC ID | 3678986643 |
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Medicare Enrollment ID | O20210112001822 |
Identifier | Type | State | Issuer |
---|---|---|---|
1124324561 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QD0000X | Clinic/center - Dental | 56687 (California) | Primary |
Provider Name | Sergio P Saucedo |
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Provider Type | Practitioner - Oral Surgery |
Provider Identifiers | NPI Number: 1578747820 PECOS PAC ID: 8921306341 Enrollment ID: I20210112002042 |
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