Full Name | |
---|---|
Speciality | Dentist |
Location | 105 E 10th St, Azusa, California |
Authorized Official Name and Position | Reuben Saucedo (PRESIDENT) |
Authorized Official Contact | 6266331080 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
105 E 10th St Azusa CA 91702-2445 Ph: (626) 633-1080 | 105 E 10th St Azusa CA 91702-2445 Ph: (626) 633-1080 |
NPI Number | 1700207883 |
---|---|
Provider Enumeration Date | 12/17/2013 |
Last Update Date | 12/17/2013 |
Identifier | Type | State | Issuer |
---|---|---|---|
1700207883 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
122300000X | Dentist | 43492 (California) | Primary |
James D. Ahn, Dds, Inc. Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 315 E Gladstone St, Azusa, CA 91702 Phone: 626-969-6728 | |
Vigliarolo Chen Canlas Dds Inc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 310 N Citrus Ave Ste A, Azusa, CA 91702 Phone: 626-804-7715 Fax: 626-507-6315 | |