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Organization
PROCARE DENTAL GROUP, JOEY S. TIRADOR D.D.S. INC.
Active
Organization
PROCARE DENTAL GROUP, JOEY S. TIRADOR D.D.S. INC.
Active
Parent organization
1538343470
Organization subpart
Yes
Provider details
NPI number
Legal business name
1538343470
Authorized official
DR. JOEY SORIANO TIRADOR DDS (PRESIDENT & CEO)
(760) 256-1189
Entity
Organization
Contact information
Practice address
12602 AMARGOSA RD, SUITE 'D', VICTORVILLE, CA 92392-7640
(760) 951-9997
(760) 962-9424
Mailing address
12602 AMARGOSA RD, SUITE 'D', VICTORVILLE, CA 92392-7640
(760) 951-9997
(760) 962-9424
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
CA 50993
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
G-94083-02
MEDI-CAL
CA
Enumeration date
12/04/2008
Last updated
09/03/2021
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