| Southridge Dental Group | |
|
14050 Cherry Ave Ste. A Fontana CA 92337-0766 | |
| (909) 822-9090 | |
| (909) 822-9094 |
| Full Name | Southridge Dental Group |
|---|---|
| Speciality | Dentist |
| Location | 14050 Cherry Ave, Fontana, California |
| Authorized Official Name and Position | Howard Glassman (DENTIST) |
| Authorized Official Contact | 9098229090 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Southridge Dental Group 14050 Cherry Ave Ste. A Fontana CA 92337-0766 Ph: (909) 822-9090 | Southridge Dental Group 14050 Cherry Ave Ste. A Fontana CA 92337-0766 Ph: (909) 822-9090 |
| NPI Number | 1497924997 |
|---|---|
| Provider Enumeration Date | 02/28/2008 |
| Last Update Date | 02/28/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497924997 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 24452 (California) | Primary |
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