| N/a | |
|
1111 Grand Ave Suite G Diamond Bar CA 91765-4171 | |
| (909) 396-7474 | |
| (909) 860-4443 |
| Full Name | N/a |
|---|---|
| Speciality | Dentist |
| Location | 1111 Grand Ave, Diamond Bar, California |
| Authorized Official Name and Position | Jay I. Bhatt (OWNER) |
| Authorized Official Contact | 9098612811 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| N/a 1111 Grand Ave Suite G Diamond Bar CA 91765-4171 Ph: (909) 396-7474 | N/a 1111 Grand Ave Suite G Diamond Bar CA 91765-4171 Ph: (909) 396-7474 |
| NPI Number | 1386860146 |
|---|---|
| Provider Enumeration Date | 04/18/2007 |
| Last Update Date | 12/23/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1386860146 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 33064 (California) | Primary |
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