Southridge Dental Group
Organization Active NPI Dentist · Fontana, CA
NPI 1497924997 · NPPES record last updated Feb 28, 2008
Key facts
- NPI
- 1497924997
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Dentist 122300000X
- License
- 24452 (CA)
- Legal business name
- SOUTHRIDGE DENTAL GROUP
- Practice address
- 14050 Cherry Ave
Ste. a
Fontana, CA 92337-0766 - Phone
- (909) 822-9090
- Fax
- (909) 822-9094
- NPI assigned
- Feb 28, 2008
- Organization subpart
- No
Authorized official
- Name
- Mr. Howard Glassman
- Title
- Dentist
- Phone
- (909) 822-9090
Corporate family (same tax ID) 1
National Provider Directory
- Tax ID family
- Phillips Ranch Dental Group
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist |
122300000X | 24452 | CA | Yes |
Addresses
Primary practice location
14050 Cherry Ave
Ste. a
Fontana, CA 92337-0766
Mailing address
14050 Cherry Ave
Ste. a
Fontana, CA 92337-0766
Phone (909) 822-9090
Other providers in Fontana, CA
- South Pacific Rehabilitation Services
- Southern California Permanente Medical Group
- Southern California Permanente Medical Group
- Southern California Permanente Medical Group
- Southern California Picc Providers, Inc.
- Lisa Lam Sparks
- Robert Speaks
- Rebecca Spence Dobias
- Clairessa M Spencer
- Kim L. Spencer
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 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.