| Prime Dental Office | |
|
1049 W Philadelphia St Ontario CA 91762-6145 | |
| (909) 391-2324 | |
| Not Available |
| Full Name | Prime Dental Office |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 1049 W Philadelphia St, Ontario, California |
| Authorized Official Name and Position | Viacheslav Zoubtsov (PRESIDENT) |
| Authorized Official Contact | 6262016278 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Prime Dental Office 2636 Greenborough Pl West Covina CA 91792-1923 Ph: () - | Prime Dental Office 1049 W Philadelphia St Ontario CA 91762-6145 Ph: (909) 391-2324 |
| NPI Number | 1295047066 |
|---|---|
| Provider Enumeration Date | 07/09/2010 |
| Last Update Date | 07/09/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295047066 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 48574 (California) | Primary |
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