Southridge Dental Group

NPI #1497924997 in Fontana, California

Provider Information

NPI Number: 1497924997
Entity Type: Organization
Organization Name: Southridge Dental Group
Primary Specialty: Dentist
Enumeration Date: Feb 28, 2008
Last Updated: Feb 28, 2008

Practice Location

Address: 14050 CHERRY AVE
Address 2: STE. A
City: Fontana
State: California
ZIP Code: 92337-0766
Phone: (909) 822-9090

Authorized Official

Name: MR. HOWARD GLASSMAN
Title: DENTIST
Phone: (909) 822-9090

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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