| Pine Center Dental Group | |
|
5771 Pine Ave #5 Chino Hills CA 91709 | |
| (909) 597-2477 | |
| (909) 597-3772 |
| Full Name | Pine Center Dental Group |
|---|---|
| Speciality | Dentist |
| Location | 5771 Pine Ave #5, Chino Hills, California |
| Authorized Official Name and Position | Hossein Abdolhosseini (OWNER) |
| Authorized Official Contact | 9095972477 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Pine Center Dental Group 5771 Pine Ave #5 Chino Hills CA 91709 Ph: (909) 597-2477 | Pine Center Dental Group 5771 Pine Ave #5 Chino Hills CA 91709 Ph: (909) 597-2477 |
| NPI Number | 1306176920 |
|---|---|
| Provider Enumeration Date | 01/04/2010 |
| Last Update Date | 11/01/2021 |
| Medicare PECOS PAC ID | 5698107035 |
|---|---|
| Medicare Enrollment ID | O20191122002261 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306176920 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 50715 (California) | Primary |
| Provider Name | Hossein Abdolhosseini |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1093853020 PECOS PAC ID: 8224460662 Enrollment ID: I20191122002351 |
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