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9130 Foothill Blvd Rancho Cucamonga CA 91730-3449 | |
| (909) 466-4999 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 9130 Foothill Blvd, Rancho Cucamonga, California |
| Authorized Official Name and Position | Magaly M Velasquez (OWNER/CEO) |
| Authorized Official Contact | 9094664999 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
9130 Foothill Blvd Rancho Cucamonga CA 91730-3449 Ph: (909) 466-4999 | 9130 Foothill Blvd Rancho Cucamonga CA 91730-3449 Ph: (909) 466-4999 |
| NPI Number | 1053652396 |
|---|---|
| Provider Enumeration Date | 03/12/2013 |
| Last Update Date | 07/28/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053652396 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 60169 (California) | Primary |
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