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General NPI Number Information
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NPI Number | 1508006586
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Entity Type | Organization
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Legal Business Name | F.H. BANEZ DENTAL CORPORATION
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Dates
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Enumeration Date | 03/03/2009
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Last Update Date | 04/17/2015
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Provider Practice Location Address
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Address Line | 2094 W REDLANDS BLVD STE F
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City | REDLANDS
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State | CA
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Zip | 92373-6266
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Country | US
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Telephone | 909-792-0500
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Fax | 909-792-0598
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Provider Business Mailing Address
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Address Line | 2094 W REDLANDS BLVD STE F
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City | REDLANDS
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State | CA
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Zip | 92373-6266
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Country | US
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Telephone | 909-792-0500
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Fax | 909-792-0598
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Authorized Official
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Title or Position | OWNER
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Name | MS. FELIZA HELEN BANEZ
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Credential | DDS
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Telephone | 909-792-0500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | 50569
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License Number State | CA
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