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12363 Limonite Ave # F106 Mira Loma CA 91752-3685 | |
(951) 360-2020 | |
(951) 360-6633 |
Full Name | |
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Speciality | Dentist - General Practice |
Location | 12363 Limonite Ave # F106, Mira Loma, California |
Authorized Official Name and Position | Vicky Presley (MANAGER) |
Authorized Official Contact | 9513602020 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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12363 Limonite Ave # F106 Mira Loma CA 91752-3685 Ph: (951) 360-2020 | 12363 Limonite Ave # F106 Mira Loma CA 91752-3685 Ph: (951) 360-2020 |
NPI Number | 1912243882 |
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Provider Enumeration Date | 12/21/2012 |
Last Update Date | 12/21/2012 |
Identifier | Type | State | Issuer |
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1912243882 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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1223G0001X | Dentist - General Practice | (California) | Primary |