| Sandy I Dizon Jr, Dds, Inc | |
|
9640 Milliken Ave Suite 104 Rancho Cucamonga CA 91730-9000 | |
| (909) 476-2821 | |
| (909) 476-2805 |
| Full Name | Sandy I Dizon Jr, Dds, Inc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 9640 Milliken Ave, Rancho Cucamonga, California |
| Authorized Official Name and Position | Sandy Inton Dizon (PRESIDENT) |
| Authorized Official Contact | 9094762821 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Sandy I Dizon Jr, Dds, Inc 9640 Milliken Ave Suite 104 Rancho Cucamonga CA 91730-9000 Ph: (909) 476-2821 | Sandy I Dizon Jr, Dds, Inc 9640 Milliken Ave Suite 104 Rancho Cucamonga CA 91730-9000 Ph: (909) 476-2821 |
| NPI Number | 1255865705 |
|---|---|
| Provider Enumeration Date | 04/11/2017 |
| Last Update Date | 04/11/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255865705 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 53059 (California) | Primary |
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