NPI | 1174417935 |
---|---|
Doing Business As | FONTANA PERIODONTICS AND IMPLANTOLOGY |
Entity Type | Organization |
Authorized Contact | TOBIAS K BOEHM Owner Dentist 909-740-4476 |
Organization Subpart ? | No |
Primary Taxonomy | 1223P0300X Dentist, Periodontics |
Enumeration Date | 2025-06-05 |
Last Update Date | 2025-06-05 |