| New Smile Dentistry | |
|
11010 Foothill Blvd Ste. 120 Rancho Cucamonga CA 91730-7616 | |
| (909) 481-8881 | |
| (909) 481-7722 |
| Full Name | New Smile Dentistry |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 11010 Foothill Blvd, Rancho Cucamonga, California |
| Authorized Official Name and Position | Villamor Rialubin Usita (PRESIDENT DENTIST) |
| Authorized Official Contact | 9094818881 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| New Smile Dentistry 11010 Foothill Blvd Ste. 120 Rancho Cucamonga CA 91730-7616 Ph: (909) 481-8881 | New Smile Dentistry 11010 Foothill Blvd Ste. 120 Rancho Cucamonga CA 91730-7616 Ph: (909) 481-8881 |
| NPI Number | 1679620439 |
|---|---|
| Provider Enumeration Date | 01/04/2007 |
| Last Update Date | 08/13/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679620439 | NPI | - | NPPES |
| 1319695 | Other | CA | UNITED CONCORDIA PROVIDER |
| B43504-01 | Other | CA | DENTI-CAL PROVIDER NUMBER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 43504 (California) | Primary |
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