Sb Lifetime Dental | |
1918 Business Center Dr Ste 210 San Bernardino CA 92408-3441 | |
(909) 881-3336 | |
(909) 890-9099 |
Full Name | Sb Lifetime Dental |
---|---|
Speciality | Dentist - General Practice |
Location | 1918 Business Center Dr Ste 210, San Bernardino, California |
Authorized Official Name and Position | Azadeh Mary Afzali (PRESIDENT) |
Authorized Official Contact | 9098813336 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Sb Lifetime Dental 1918 Business Center Dr Ste 210 San Bernardino CA 92408-3441 Ph: (909) 881-3336 | Sb Lifetime Dental 1918 Business Center Dr Ste 210 San Bernardino CA 92408-3441 Ph: (909) 881-3336 |
NPI Number | 1669833810 |
---|---|
Provider Enumeration Date | 03/16/2016 |
Last Update Date | 03/16/2016 |
Identifier | Type | State | Issuer |
---|---|---|---|
1669833810 | NPI | - | NPPES |
55014 | Other | CA | CALIFORNIA DENTAL LICENCE |
64657 | Other | CA | CALIFORNIA DENTAL LICENCE |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
122300000X | Dentist | 64657 (California) | Secondary |
1223G0001X | Dentist - General Practice | 55014 (California) | Primary |
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