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19009 Van Buren Blvd Suite 204 Riverside CA 92508-9164 | |
| (951) 776-9001 | |
| (951) 680-1995 |
| Full Name | |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 19009 Van Buren Blvd, Riverside, California |
| Authorized Official Name and Position | Catherine Bailey (PATIENT ACCOUNTING MANAGER) |
| Authorized Official Contact | 9512417201 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
19009 Van Buren Blvd Suite 204 Riverside CA 92508-9164 Ph: (951) 776-9001 | 19009 Van Buren Blvd Suite 204 Riverside CA 92508-9164 Ph: (951) 776-9001 |
| NPI Number | 1134314818 |
|---|---|
| Provider Enumeration Date | 09/06/2007 |
| Last Update Date | 09/02/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134314818 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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