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Organization
SANDY I DIZON JR, DDS, INC
Active
Organization
SANDY I DIZON JR, DDS, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SANDY INTON DIZON JR. D.D.S. (PRESIDENT)
(909) 476-2821
Entity
Organization
Contact information
Practice address
9640 MILLIKEN AVE, SUITE 104, RANCHO CUCAMONGA, CA 91730-9000
(909) 476-2821
(909) 476-2805
Mailing address
9640 MILLIKEN AVE, SUITE 104, RANCHO CUCAMONGA, CA 91730-9000
(909) 476-2821
(909) 476-2805
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
53059
CA
Other
Enumeration date
04/11/2017
Last updated
04/11/2017
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