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Organization
HESPERIA DENTAL CENTER INC.
Active
Organization
HESPERIA DENTAL CENTER INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KENNETH J. BRUST D.D.S. (DENTIST)
(760) 244-7232
Entity
Organization
Contact information
Practice address
16990 MAIN ST, SUITE 1, HESPERIA, CA 92345-7919
(760) 244-7232
(760) 244-5104
Mailing address
16990 MAIN ST, SUITE 1, HESPERIA, CA 92345-7919
(760) 244-7232
(760) 244-5104
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
43905
CA
Other
Enumeration date
10/11/2016
Last updated
10/11/2016
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