| Fresh Smile Dental | |
|
1666 Medical Center Dr Ste 3 San Bernardino CA 92411-1257 | |
| (909) 881-5007 | |
| Not Available |
| Full Name | Fresh Smile Dental |
|---|---|
| Speciality | Clinic/Center |
| Location | 1666 Medical Center Dr Ste 3, San Bernardino, California |
| Authorized Official Name and Position | Freddy Zambrano (DENTIST) |
| Authorized Official Contact | 8186608196 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Fresh Smile Dental 1666 Medical Center Dr Ste 3 San Bernardino CA 92411-1257 Ph: (909) 881-5007 | Fresh Smile Dental 1666 Medical Center Dr Ste 3 San Bernardino CA 92411-1257 Ph: (909) 881-5007 |
| NPI Number | 1447593330 |
|---|---|
| Provider Enumeration Date | 03/29/2013 |
| Last Update Date | 08/16/2021 |
| Medicare PECOS PAC ID | 2961835822 |
|---|---|
| Medicare Enrollment ID | O20191206000562 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1447593330 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
| Provider Name | Lourdes M Alvarado |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1114104205 PECOS PAC ID: 0244662971 Enrollment ID: I20191118001258 |
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