| Moreno Dental Care | |
|
23750 Alessandro Blvd Suite O-102 Moreno Valley CA 92553-8811 | |
| (951) 656-0088 | |
| (951) 656-0034 |
| Full Name | Moreno Dental Care |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 23750 Alessandro Blvd, Moreno Valley, California |
| Authorized Official Name and Position | Charles C Park (PRESIDENT) |
| Authorized Official Contact | 9516560088 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Moreno Dental Care 23750 Alessandro Blvd Suite O-102 Moreno Valley CA 92553-8811 Ph: (951) 656-0088 | Moreno Dental Care 23750 Alessandro Blvd Suite O-102 Moreno Valley CA 92553-8811 Ph: (951) 656-0088 |
| NPI Number | 1699969998 |
|---|---|
| Provider Enumeration Date | 08/29/2007 |
| Last Update Date | 08/29/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699969998 | NPI | - | NPPES |
| G89861-01 | Other | CA | DENTI-CAL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 50087 (California) | Primary |
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