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1160 E Ontario Ave Suite 102 & 103 Corona CA 92881-8653 | |
| (310) 820-9933 | |
| (310) 820-0408 |
| Full Name | |
|---|---|
| Speciality | Dentist |
| Location | 1160 E Ontario Ave, Corona, California |
| Authorized Official Name and Position | Soleyman Cohen Sedgh (OWNER) |
| Authorized Official Contact | 3108209933 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
1160 E Ontario Ave Suite 102 & 103 Corona CA 92881-8653 Ph: (310) 820-9933 | 1160 E Ontario Ave Suite 102 & 103 Corona CA 92881-8653 Ph: (310) 820-9933 |
| NPI Number | 1376975706 |
|---|---|
| Provider Enumeration Date | 08/08/2013 |
| Last Update Date | 06/27/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376975706 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 38979 (California) | Primary |
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