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34366 Yucaipa Blvd Ste K Yucaipa CA 92399-2497 | |
| (909) 754-5659 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Dentist |
| Location | 34366 Yucaipa Blvd Ste K, Yucaipa, California |
| Authorized Official Name and Position | Neal Antonio Johnson (OWNER) |
| Authorized Official Contact | 9097545659 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
34366 Yucaipa Blvd Ste K Yucaipa CA 92399-2497 Ph: (909) 797-9247 | 34366 Yucaipa Blvd Ste K Yucaipa CA 92399-2497 Ph: (909) 754-5659 |
| NPI Number | 1023894326 |
|---|---|
| Provider Enumeration Date | 09/04/2023 |
| Last Update Date | 04/25/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023894326 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | (* (Not Available)) | Primary |
| 1223D0004X | Dentist - Dentist Anesthesiologist | (* (Not Available)) | Secondary |
Mauricio Dossantos Dds Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 12033 4th St, Suite 7, Yucaipa, CA 92399 Phone: 909-790-1951 Fax: 909-790-1561 | |
Jorge Enciso, Dds, Inc. Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 34366 Yucaipa Blvd Ste K, Yucaipa, CA 92399 Phone: 909-797-9247 Fax: 909-797-8587 | |
Peter N Jimenez Dds A Professional Dental Corporation Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 31646 Dunlap Blvd Unit C, Yucaipa, CA 92399 Phone: 909-794-4909 Fax: 909-794-4904 |