Fontana Dental Clinic

NPI #1639476765 in Fontana, California

Provider Information

NPI Number: 1639476765
Entity Type: Organization
Organization Name: Fontana Dental Clinic
Primary Specialty: Dentist - General Practice
Enumeration Date: Feb 25, 2011
Last Updated: Feb 25, 2011

Practice Location

Address: 16989 VALLEY BLVD
Address 2: SUITE B
City: Fontana
State: California
ZIP Code: 92335-6806
Phone: (909) 829-3535

Authorized Official

Name: JOSE ALFREDO VELAZQUEZ, DDS
Title: PRESIDENT
Phone: (909) 829-3535

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - General Practice — General Practice	1223G0001X	Primary

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