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Organization
LOMA LINDA UNIVERSITY SCHOOL OF DENTISTRY
Active
Organization
LOMA LINDA UNIVERSITY SCHOOL OF DENTISTRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RODNEY DALE NEAL (SR. VICE PRESIDENT)
(909) 558-4543
Entity
Organization
Contact information
Practice address
11092 ANDERSON ST, LOMA LINDA, CA 92350-1706
(909) 558-4613
(909) 558-4192
Mailing address
11092 ANDERSON ST, LOMA LINDA, CA 92350-1706
(909) 558-4613
(909) 558-4192
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
2056
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2056
STATE LICENSE NUMBER
—
Enumeration date
10/03/2007
Last updated
03/18/2020
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