Healthcare Provider Details

I. General information

NPI: 1033263298
Provider Name (Legal Business Name): JAMES PATRICK CALEY DDS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/23/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1856 MENTONE BLVD STE B
MENTONE CA
92359-1276
US

IV. Provider business mailing address

419 BROOKSIDE AVE
REDLANDS CA
92373-4667
US

V. Phone/Fax

Practice location:
  • Phone: 909-794-7310
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberB35229
License Number StateCA

VIII. Authorized Official

Name: DR. JAMES PATRICK CALEY
Title or Position: OWNER
Credential: DDS
Phone: 909-798-5117