Phillips Ranch Dental Group
Organization Active NPI Dentist · Phillips Ranch, CA
NPI 1427201151 · NPPES record last updated Oct 28, 2008
Key facts
- NPI
- 1427201151
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Dentist 122300000X
- License
- 24452 (CA)
- Legal business name
- PHILLIPS RANCH DENTAL GROUP
- Practice address
- 4 Village Loop Rd
B2
Phillips Ranch, CA 91766-4891 - Phone
- (909) 620-0321
- Fax
- (909) 620-0324
- NPI assigned
- Oct 28, 2008
- Organization subpart
- No
Authorized official
- Name
- Mrs. Jodie Ann Ramirez
- Title
- Executive Director
- Phone
- (909) 620-0321
Corporate family (same tax ID) 1
National Provider Directory
- Tax ID family
- Phillips Ranch Dental Group
Locations
4 Village Loop Rd
#B2
Phillips Ranch, CA 91766
Phone (909) 620-0321
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist |
122300000X | 24452 | CA | Yes |
Addresses
Primary practice location
4 Village Loop Rd
B2
Phillips Ranch, CA 91766-4891
Mailing address
4 Village Loop Rd
B2
Phillips Ranch, CA 91766-4891
Other providers in Phillips Ranch, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 28, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.