| NPI | 1669540084 |
|---|---|
| Doing Business As | NORTH HEACOCK DENTAL GROUP |
| Entity Type | Organization |
| Authorized Contact | DAVID L REAGAN Owner/Partner 951-247-7040 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA dh32166) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CA db31029) |
| Enumeration Date | 2006-12-01 |
| Last Update Date | 2020-01-20 |