| Full Name | |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 6862 Palm Ave, Riverside, California |
| Authorized Official Name and Position | Wayne R Low (PRESIDENT) |
| Authorized Official Contact | 9516835490 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
6862 Palm Ave Riverside CA 92506 Ph: (951) 683-5490 | 6862 Palm Ave Riverside CA 92506 Ph: (951) 683-5490 |
| NPI Number | 1255434676 |
|---|---|
| Provider Enumeration Date | 09/07/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255434676 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 34373 (California) | Primary |
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