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General NPI Number Information
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NPI Number | 1356810600
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Entity Type | Organization
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Legal Business Name | ZALA DENTAL INC
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Dates
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Enumeration Date | 11/15/2018
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Last Update Date | 11/15/2018
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Provider Practice Location Address
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Address Line | 12376 LIMONITE AVE STE 250
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City | EASTVALE
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State | CA
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Zip | 91752-3519
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Country | US
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Telephone | 951-456-4646
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Fax |
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Provider Business Mailing Address
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Address Line | 12376 LIMONITE AVE STE 250
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City | EASTVALE
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State | CA
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Zip | 91752-3519
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Country | US
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Telephone | 951-456-4646
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Fax |
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Authorized Official
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Title or Position | OWNER DENTIST
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Name | DR. MITESH ZALA
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Credential | DDS
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Telephone | 562-229-4182
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number |
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License Number State |
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