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10333 Hole Ave Riverside CA 92505-1747 | |
| (951) 688-7150 | |
| (951) 688-0184 |
| Full Name | |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 10333 Hole Ave, Riverside, California |
| Authorized Official Name and Position | Robert Blaine Perry (OWNER) |
| Authorized Official Contact | 9516887150 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
10333 Hole Ave Riverside CA 92505-1747 Ph: (951) 688-7150 | 10333 Hole Ave Riverside CA 92505-1747 Ph: (951) 688-7150 |
| NPI Number | 1235478256 |
|---|---|
| Provider Enumeration Date | 02/12/2013 |
| Last Update Date | 02/12/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235478256 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 20038 (California) | Primary |
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