| Full Name | |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 12136 4th St, Yucaipa, California |
| Authorized Official Name and Position | Claudia Monica Uribe (OFFICE MANAGER) |
| Authorized Official Contact | 9097904478 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
12136 4th St Yucaipa CA 92399 Ph: (909) 790-4478 | 12136 4th St Yucaipa CA 92399 Ph: (909) 790-4478 |
| NPI Number | 1013046861 |
|---|---|
| Provider Enumeration Date | 03/05/2007 |
| Last Update Date | 02/24/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013046861 | NPI | - | NPPES |
| G9411401 | Other | CA | DENTICAL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
Mauricio Dossantos Dds Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 12033 4th St, Suite 7, Yucaipa, CA 92399 Phone: 909-790-1951 Fax: 909-790-1561 | |
Jorge Enciso, Dds, Inc. Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 34366 Yucaipa Blvd Ste K, Yucaipa, CA 92399 Phone: 909-797-9247 Fax: 909-797-8587 | |
Peter N Jimenez Dds A Professional Dental Corporation Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 31646 Dunlap Blvd Unit C, Yucaipa, CA 92399 Phone: 909-794-4909 Fax: 909-794-4904 |