| San Gabriel Valley Oral And Facial Surgery | |
|
126 S Glendora Ave Ste 108 West Covina CA 91790-3047 | |
| (626) 966-8518 | |
| (626) 967-0990 |
| Full Name | San Gabriel Valley Oral And Facial Surgery |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 126 S Glendora Ave Ste 108, West Covina, California |
| Authorized Official Name and Position | Patty K Bogle (PRACTICE ADMINISTRATOR) |
| Authorized Official Contact | 6269668518 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| San Gabriel Valley Oral And Facial Surgery 126 S Glendora Ave Ste 108 West Covina CA 91790-3047 Ph: (626) 966-8518 | San Gabriel Valley Oral And Facial Surgery 126 S Glendora Ave Ste 108 West Covina CA 91790-3047 Ph: (626) 966-8518 |
| NPI Number | 1679086243 |
|---|---|
| Provider Enumeration Date | 11/06/2017 |
| Last Update Date | 03/17/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679086243 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 40257 (California) | Primary |
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