| NPI | 1366253007 |
|---|---|
| Doing Business As | MOUNTAINSIDE DENTAL GROUP |
| Entity Type | Organization |
| Authorized Contact | STEVEN WOLFRAM Owner 909-528-8158 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2025-01-14 |
| Last Update Date | 2025-01-14 |