in San Bernardino - Orthodontics And Dentofacial Orthopedics
- NPI 1164572053
is a Orthodontics And Dentofacial Orthopedics in San Bernardino, California. practices all healthcare services and medical treatments related to Orthodontics And Dentofacial Orthopedics. The NPI Number for is 1164572053. The last update date is .
's current location address is 1655 N Mount Vernon Ave, San Bernardino, California. You can contact this provider via phone number 9098858707 and fax number 9098859447. The mailing address for is 1655 N Mount Vernon Ave, San Bernardino, California. To know further, please read the information below!
Provider Profile Detail
Provider Name | |
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Address | 1655 N Mount Vernon Ave, San Bernardino, California |
Phone Number | 9098858707 |
Fax Number | 9098859447 |
Sole Proprietor | -- |
Credentials | -- |
NPI Number Detail
NPI Number | 1164572053 |
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Provider Enumeration Date | |
Last Updated Date |
Provider Mailing Address Detail
Address | 1655 N Mount Vernon Ave |
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City | San Bernardino |
State | California (CA) |
Post Code | 924111427 |
Phone Number | 9098858707 |
Fax Number | 9098859447 |
Provider's Primary Taxonomy Detail
Speciality | Orthodontics And Dentofacial Orthopedics |
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Taxonomy | 1223X0400X |
Licence No | 51082 |
Definition: That area of dentistry concerned with the supervision, guidance and correction of the growing or mature dentofacial structures, including those conditions that require movement of teeth or correction of malrelationships and malformations of their rel |
Provider's Other Legacy Identifiers
Identifier | Identifier Type | Identifier State | Identifier Issuer |
---|---|---|---|
161-9568 | CA | UNITED CONCORDIA | |
G94087-01 | CA | DENTI-CAL |
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