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General NPI Number Information
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NPI Number | 1174475792
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Entity Type | Organization
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Legal Business Name | GOOD TIMES DENTAL, PROFESSIONAL CORPORATION
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Dates
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Enumeration Date | 02/14/2026
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Last Update Date | 02/14/2026
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Provider Practice Location Address
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Address Line | 944 VIA LATA
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City | COLTON
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State | CA
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Zip | 92324-3918
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Country | US
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Telephone | 909-533-4244
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Fax |
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Provider Business Mailing Address
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Address Line | 944 VIA LATA
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City | COLTON
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State | CA
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Zip | 92324-3918
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Country | US
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Telephone | 909-533-4244
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Fax |
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Authorized Official
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Title or Position | DR.
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Name | DR. VIJAY MOHAMED
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Credential | DR.
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Telephone | 615-946-8805
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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