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General NPI Number Information
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NPI Number | 1679693162
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Entity Type | Organization
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Legal Business Name | OSCAR A. GOCHEZ DDS A PROFESSIONAL DENTAL CORP.
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Dates
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Enumeration Date | 03/30/2007
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Last Update Date | 08/31/2021
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Provider Practice Location Address
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Address Line | 12716 S CENTRAL AVE
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City | CHINO
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State | CA
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Zip | 91710
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Country | US
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Telephone | 909-628-5133
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Fax | 909-628-2938
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Provider Business Mailing Address
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Address Line | 12716 S CENTRAL AVE
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City | CHINO
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State | CA
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Zip | 91710
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Country | US
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Telephone | 909-628-5133
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Fax | 909-628-2938
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Authorized Official
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Title or Position | DDS
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Name | OSCAR GOCHEZ
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Credential |
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Telephone | 909-628-5133
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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 | 35109
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License Number State | CA
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