| NPI | 1902003593 |
|---|---|
| Doing Business As | SIERRA LAKES DENTAL GROUP |
| Entity Type | Organization |
| Authorized Contact | WALTER JEFFERSON Owner 909-357-0869 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice |
| Enumeration Date | 2007-06-28 |
| Last Update Date | 2020-08-22 |