Aesthetic Dental Group Inc
Organization Active NPI Dental Clinic/Center · Glendora, CA
NPI 1629637376 · NPPES record last updated Feb 13, 2025
Key facts
- NPI
- 1629637376
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Dental Clinic/Center 261QD0000X
- Legal business name
- AESTHETIC DENTAL GROUP INC
- Practice address
- 415 W Route 66 Ste 201
Glendora, CA 91740-4335 - Phone
- (626) 914-0020
- Fax
- (626) 914-0023
- NPI assigned
- Jun 6, 2019
- Organization subpart
- No
Authorized official
- Name
- William J Rouhana
- Title
- Dentist
- Phone
- (626) 914-0020
National Provider Directory
Locations
2640 E Garvey Ave S
Ste 102
West Covina, CA 91791
Phone (626) 859-2777
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dental Clinic/Center | 261QD0000X | Yes |
Addresses
Primary practice location
415 W Route 66 Ste 201
Glendora, CA 91740-4335
Mailing address
415 W Route 66 Ste 201
Glendora, CA 91740-4335
Phone (626) 914-0020
Other names
- Aesthetic dental group inc
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 13, 2025. 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.