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Organization
ST MOISES DENTAL
Active
Organization
ST MOISES DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
UBLESTER GOMEZ DDS (PRESIDENT/OWNER)
(909) 865-8500
Entity
Organization
Contact information
Practice address
12 RANCHO CAMINO DR STE 102, POMONA, CA 91766-7008
(909) 865-8500
Mailing address
12 RANCHO CAMINO DR STE 102, POMONA, CA 91766-7008
(909) 865-8500
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
46064
CA
Other
Enumeration date
07/26/2008
Last updated
07/26/2008
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