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General NPI Number Information
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NPI Number | 1992117428
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Entity Type | Organization
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Legal Business Name | NUEVO SMILE DENTAL MANAGEMENT CORPORATION
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Dates
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Enumeration Date | 06/02/2014
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Last Update Date | 06/02/2014
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Provider Practice Location Address
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Address Line | 29616 NUEVO RD SUITE A4
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City | NUEVO
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State | CA
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Zip | 92567-9201
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Country | US
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Telephone | 951-377-4157
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Fax |
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Provider Business Mailing Address
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Address Line | 29616 NUEVO RD SUITE A4
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City | NUEVO
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State | CA
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Zip | 92567-9201
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Country | US
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Telephone | 951-377-4157
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MS. ELIZABETH ZENDEJAS
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Credential |
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Telephone | 951-377-4157
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 126800000X
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Taxonomy Name | Dental Assistant
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License Number |
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License Number State |
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