| Magicland Children's Dentistry & Orthodontics Dental Group | |
|
4176 Pyrite Street Building 10 Jurupa Valley CA 92569 | |
| (310) 820-9933 | |
| (310) 820-0408 |
| Full Name | Magicland Children's Dentistry & Orthodontics Dental Group |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 4176 Pyrite Street, Jurupa Valley, California |
| Authorized Official Name and Position | Miguel Reyes (Q/A CONTRACT & COMPLIANCE MANAGER) |
| Authorized Official Contact | 3104094225 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Magicland Children's Dentistry & Orthodontics Dental Group 12121 Wilshire Blvd Ste 1111 Los Angeles CA 90025-1188 Ph: (310) 820-9933 | Magicland Children's Dentistry & Orthodontics Dental Group 4176 Pyrite Street Building 10 Jurupa Valley CA 92569 Ph: (310) 820-9933 |
| NPI Number | 1861179202 |
|---|---|
| Provider Enumeration Date | 06/28/2023 |
| Last Update Date | 09/04/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861179202 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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