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7211 Haven Ave Ste # D Rancho Cucamonga CA 91701-6064 | |
| (909) 256-8484 | |
| (909) 256-8493 |
| Full Name | |
|---|---|
| Speciality | Dentist |
| Location | 7211 Haven Ave, Rancho Cucamonga, California |
| Authorized Official Name and Position | Keyurkumar Ratilal Patel (CEO) |
| Authorized Official Contact | 9092670970 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
7211 Haven Ave Ste # D Rancho Cucamonga CA 91701-6064 Ph: (909) 256-8484 | 7211 Haven Ave Ste # D Rancho Cucamonga CA 91701-6064 Ph: (909) 256-8484 |
| NPI Number | 1053789826 |
|---|---|
| Provider Enumeration Date | 09/09/2015 |
| Last Update Date | 09/09/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053789826 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 54570 (California) | Primary |
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