| NPI | 1902402456 |
|---|---|
| Doing Business As | WEST COAST DENTAL GROUP OF RIALTO |
| Entity Type | Organization |
| Authorized Contact | MIGUEL REYES Q/A Contract & Compliance Manager 310-409-4225 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist |
| Enumeration Date | 2020-12-09 |
| Last Update Date | 2020-12-09 |