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General NPI Number Information
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NPI Number | 1376722595
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Entity Type | Organization
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Legal Business Name | PRINCESITA A. BILLEDO D.D.S., INC
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Dates
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Enumeration Date | 10/25/2007
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Last Update Date | 10/25/2007
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Provider Practice Location Address
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Address Line | 1755 S MOUNTAIN AVE STE. A
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City | ONTARIO
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State | CA
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Zip | 91762-5972
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Country | US
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Telephone | 909-460-7776
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Fax | 909-460-7677
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Provider Business Mailing Address
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Address Line | 1755 S MOUNTAIN AVE STE. A
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City | ONTARIO
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State | CA
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Zip | 91762-5972
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Country | US
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Telephone | 909-460-7776
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Fax | 909-460-7677
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. PRINCESITA ASUNCION BILLEDO
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Credential | DDS
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Telephone | 909-460-7776
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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 | 43420
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License Number State | CA
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