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Organization
JEBCOB
Active
Organization
JEBCOB
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. OSCAR ESPARZA D.D.S. (DENTIST)
(909) 984-3618
Entity
Organization
Contact information
Practice address
527 N PALM AVE, SUITE 106, ONTARIO, CA 91762-3215
(909) 984-3618
(909) 984-9479
Mailing address
527 N PALM AVE STE 106, ONTARIO, CA 91762-3215
(909) 984-3618
(909) 984-9479
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
41648
CA
122300000X
Dentist
45252
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10442-1
BLUE SHIELD
CA
01
—
828309
UNITED CONCORDIA
CA
05
—
B41648-01
—
CA
05
—
D45252--01
—
CA
Enumeration date
02/06/2007
Last updated
07/10/2007
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