| |
14323 E Ramona Blvd Baldwin Park CA 91706-3242 | |
(626) 962-8160 | |
(626) 962-8170 |
Full Name | |
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Speciality | Dentist - General Practice |
Location | 14323 E Ramona Blvd, Baldwin Park, California |
Authorized Official Name and Position | Ernesto M Tena (PRESIDENT OWNER) |
Authorized Official Contact | 6269628160 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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607 E Arrow Hwy Azusa CA 91702 Ph: (626) 915-3616 | 14323 E Ramona Blvd Baldwin Park CA 91706-3242 Ph: (626) 962-8160 |
NPI Number | 1891802864 |
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Provider Enumeration Date | 08/24/2006 |
Last Update Date | 08/22/2020 |
Identifier | Type | State | Issuer |
---|---|---|---|
1891802864 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1223G0001X | Dentist - General Practice | 48389 (California) | Primary |
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