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1060 Harriman Pl # C-3 San Bernardino CA 92408-4204 | |
| (909) 799-7777 | |
| (909) 799-0044 |
| Full Name | |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 1060 Harriman Pl # C-3, San Bernardino, California |
| Authorized Official Name and Position | Lyngladen Fernandez (OWNER) |
| Authorized Official Contact | 9097997777 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
1060 Harriman Pl # C-3 San Bernardino CA 92408-4204 Ph: (909) 799-7777 | 1060 Harriman Pl # C-3 San Bernardino CA 92408-4204 Ph: (909) 799-7777 |
| NPI Number | 1255653473 |
|---|---|
| Provider Enumeration Date | 02/16/2010 |
| Last Update Date | 02/16/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255653473 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 54428 (California) | Primary |
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