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General NPI Number Information
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NPI Number | 1649916693
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Entity Type | Organization
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Legal Business Name | OJG INC
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Dates
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Enumeration Date | 05/11/2022
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Last Update Date | 05/11/2022
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Provider Practice Location Address
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Address Line | 17185 ARROW BLVD
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City | FONTANA
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State | CA
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Zip | 92335-3972
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Country | US
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Telephone | 909-587-2474
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Fax |
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Provider Business Mailing Address
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Address Line | 12716 CENTRAL AVE
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City | CHINO
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State | CA
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Zip | 91710-3510
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | OSCAR A GOCHEZ SR.
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Credential | D.D.S
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Telephone | 213-574-2656
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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 |
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License Number State |
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