| NPI | 1609390582 |
|---|---|
| Doing Business As | DENTAL PRACTICE OF SAN BERNARDINO |
| Entity Type | Organization |
| Authorized Contact | MYRON LLOYD MASSEY President/Owner 909-709-5657 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: CA 61417) |
| Enumeration Date | 2017-08-01 |
| Last Update Date | 2022-07-21 |