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General NPI Number Information
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NPI Number | 1508094061
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Entity Type | Organization
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Legal Business Name | INLAND DENTISTRY, INC
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Dates
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Enumeration Date | 06/23/2009
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Last Update Date | 06/23/2009
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Provider Practice Location Address
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Address Line | 10411 MAGNOLIA AVE SUITE A
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City | RIVERSIDE
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State | CA
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Zip | 92505-1894
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Country | US
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Telephone | 951-352-7260
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Fax | 951-352-6237
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Provider Business Mailing Address
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Address Line | 10411 MAGNOLIA AVE SUITE A
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City | RIVERSIDE
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State | CA
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Zip | 92505-1894
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Country | US
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Telephone | 951-352-7260
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Fax | 951-352-6237
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Authorized Official
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Title or Position | DENTIST/OWNER
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Name | MRS. MANUEL R ARTEAGA
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Credential | D.D.S.
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Telephone | 951-352-7260
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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 | 43310
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License Number State | CA
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