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General NPI Number Information
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NPI Number | 1861850091
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Entity Type | Organization
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Legal Business Name | ALVAREZ & BERNARDO DENTAL CORPORATIO
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Dates
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Enumeration Date | 02/02/2016
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Last Update Date | 02/02/2016
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Provider Practice Location Address
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Address Line | 24655 SUNNYMEAD BLVD
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City | MORENO VALLEY
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State | CA
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Zip | 92553-3760
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Country | US
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Telephone | 951-242-6088
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Fax | 951-242-5050
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Provider Business Mailing Address
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Address Line | 24655 SUNNYMEAD BLVD
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City | MORENO VALLEY
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State | CA
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Zip | 92553-3760
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Country | US
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Telephone | 951-242-6088
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Fax | 951-242-5050
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Authorized Official
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Title or Position | PRESIDENT/OWNER
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Name | DR. SERAFIN LABAO BERNARDO JR.
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Credential | DDS
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Telephone | 951-242-6088
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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 | 37788
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License Number State | CA
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