| NPI | 1619721297 |
|---|---|
| Doing Business As | FORMICA FAMILY DENTAL PRACTICE EDWARD J FORMICA DDS, INC. |
| Entity Type | Organization |
| Authorized Contact | EDWARD J FORMICA CEO/President 951-925-6444 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2024-04-11 |
| Last Update Date | 2024-07-09 |