| NPI | 1992899777 |
|---|---|
| Doing Business As | REDLANDS DENTAL GROUP |
| Entity Type | Organization |
| Authorized Contact | TANISHA A JACKSON Owner Dds 909-792-7500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 47103) |
| Additional Taxonomies | 1223P0300X Dentist, Periodontics (Licence: CA 43860) |
| 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: CA 51692) | |
| 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: CA 50851) | |
| Enumeration Date | 2006-10-03 |
| Last Update Date | 2020-08-22 |