Sudan Dental Corporation

NPI #1912441148 in Chino, California

Provider Information

NPI Number: 1912441148
Entity Type: Organization
Organization Name: Sudan Dental Corporation
Primary Specialty: Dentist
Enumeration Date: Dec 7, 2016
Last Updated: Dec 7, 2016

Practice Location

Address: 4110 EDISON AVE
Address 2: 107-B
City: Chino
State: California
ZIP Code: 91710-8409
Phone: (909) 536-1900

Authorized Official

Name: ANISHA SUDAN, DDS
Title: OWNER
Phone: (909) 536-1900

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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