| M Nosrati Dental Corporation | |
|
13677 Foothill Blvd Ste M Fontana CA 92335-0214 | |
| (909) 330-2273 | |
| Not Available |
| Full Name | M Nosrati Dental Corporation |
|---|---|
| Speciality | Clinic/Center |
| Location | 13677 Foothill Blvd Ste M, Fontana, California |
| Authorized Official Name and Position | Mahin Nosrati-jahromi (OWNER DENTIST) |
| Authorized Official Contact | 9093302273 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| M Nosrati Dental Corporation 13677 Foothill Blvd Ste M Fontana CA 92335-0214 Ph: (909) 330-2273 | M Nosrati Dental Corporation 13677 Foothill Blvd Ste M Fontana CA 92335-0214 Ph: (909) 330-2273 |
| NPI Number | 1750894374 |
|---|---|
| Provider Enumeration Date | 11/06/2017 |
| Last Update Date | 01/21/2022 |
| Medicare PECOS PAC ID | 4880029909 |
|---|---|
| Medicare Enrollment ID | O20200120000498 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750894374 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 53932 (California) | Primary |
| Provider Name | Mahin Nosrati-jahromi |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1568633139 PECOS PAC ID: 5799110813 Enrollment ID: I20200120000536 |
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