| |
2117 Foothill Blvd Ste C La Verne CA 91750-2902 | |
(909) 593-7171 | |
(909) 593-7603 |
Full Name | |
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Speciality | Clinic/center - Dental |
Location | 2117 Foothill Blvd Ste C, La Verne, California |
Authorized Official Name and Position | Shirley S. Hirayama (MANAGER) |
Authorized Official Contact | 9095937171 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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2117 Foothill Blvd Ste C La Verne CA 91750-2902 Ph: (909) 593-7171 | 2117 Foothill Blvd Ste C La Verne CA 91750-2902 Ph: (909) 593-7171 |
NPI Number | 1649788696 |
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Provider Enumeration Date | 01/11/2018 |
Last Update Date | 06/16/2018 |
Identifier | Type | State | Issuer |
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1649788696 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QD0000X | Clinic/center - Dental | 32093 (California) | Primary |
Inland Dental Group Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1131 Foothill Blvd, La Verne, CA 91750 Phone: 909-596-6551 | |
Inland Dental Group Of Hemant V. Patel Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1131 Foothill Blvd, La Verne, CA 91750 Phone: 909-596-6551 Fax: 909-596-0925 | |
Nigoghosian Dental Group Inc Dental Clinic Medicare: Medicare Enrolled Practice Location: 2488 Foothill Blvd Ste C, La Verne, CA 91750 Phone: 909-596-1155 | |