| Sumilat Dds, Inc. | |
|
11481 Heacock St Ste 160 Moreno Valley CA 92557-7906 | |
| (909) 824-3126 | |
| Not Available |
| Full Name | Sumilat Dds, Inc. |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 11481 Heacock St Ste 160, Moreno Valley, California |
| Authorized Official Name and Position | James Sumilat (C.E.O.) |
| Authorized Official Contact | 9098243126 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Sumilat Dds, Inc. 3053 Prado Ln Colton CA 92324-9545 Ph: (909) 824-3126 | Sumilat Dds, Inc. 11481 Heacock St Ste 160 Moreno Valley CA 92557-7906 Ph: (909) 824-3126 |
| NPI Number | 1790325140 |
|---|---|
| Provider Enumeration Date | 01/14/2020 |
| Last Update Date | 01/14/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790325140 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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