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General NPI Number Information
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NPI Number | 1750585683
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Entity Type | Organization
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Legal Business Name | DR. AHUJA AND DR. GILL'S DENTAL OFFICE
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Dates
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Enumeration Date | 06/13/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 224 E BASE LINE RD
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City | RIALTO
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State | CA
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Zip | 92376-3506
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Country | US
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Telephone | 909-874-4699
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Fax | 909-874-4689
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Provider Business Mailing Address
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Address Line | 224 E BASE LINE RD
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City | RIALTO
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State | CA
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Zip | 92376-3506
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Country | US
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Telephone | 909-874-4699
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Fax | 909-874-4689
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | ESTHER FABILA
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Credential |
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Telephone | 909-874-4699
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | D43412
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License Number State | CA
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