| Valleywide Dental | |
|
1021 W Avenue M14 Palmdale CA 93551-1440 | |
| (661) 267-4000 | |
| (661) 267-4018 |
| Full Name | Valleywide Dental |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 1021 W Avenue M14, Palmdale, California |
| Authorized Official Name and Position | Robert Haze (OWNER) |
| Authorized Official Contact | 6612674000 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Valleywide Dental 1021 W Avenue M14 Palmdale CA 93551-1440 Ph: (661) 267-4000 | Valleywide Dental 1021 W Avenue M14 Palmdale CA 93551-1440 Ph: (661) 267-4000 |
| NPI Number | 1992133318 |
|---|---|
| Provider Enumeration Date | 10/22/2013 |
| Last Update Date | 06/09/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992133318 | NPI | - | NPPES |
| 1972629640 | Other | CA | DENTI-CAL |
| 1992133318 | Other | CA | DENTI-CAL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 35883 (California) | Primary |
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