| Irene M Justin Wildwood Dental Group | |
|
3972 N Waterman Ave Ste 110 San Bernardino CA 92404-1767 | |
| (909) 947-9700 | |
| Not Available |
| Full Name | Irene M Justin Wildwood Dental Group |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 3972 N Waterman Ave Ste 110, San Bernardino, California |
| Authorized Official Name and Position | Irene Justin (PRESIDENT) |
| Authorized Official Contact | 9515368419 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Irene M Justin Wildwood Dental Group 2413 S Grove Ave Ontario CA 91761-6225 Ph: (909) 947-9700 | Irene M Justin Wildwood Dental Group 3972 N Waterman Ave Ste 110 San Bernardino CA 92404-1767 Ph: (909) 947-9700 |
| NPI Number | 1689900870 |
|---|---|
| Provider Enumeration Date | 10/23/2009 |
| Last Update Date | 10/23/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689900870 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 51084 (California) | Primary |
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