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Organization
GUPTA DENTAL OFFICE
Active
Organization
GUPTA DENTAL OFFICE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JUGAL K GUPTA DDS (DENTIST / OWNER)
(909) 356-9752
Entity
Organization
Contact information
Practice address
16049 BASELINE AVE UNIT 3, FONTANA, CA 92336-1861
(909) 356-9752
Mailing address
16049 BASELINE AVE UNIT 3, FONTANA, CA 92336-1861
(909) 356-9752
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
36370
CA
Other
Enumeration date
08/31/2009
Last updated
08/31/2009
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