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Organization
PHILLIPS RANCH DENTAL GROUP
Active
Organization
PHILLIPS RANCH DENTAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JODIE ANN RAMIREZ (EXECUTIVE DIRECTOR)
(909) 620-0321
Entity
Organization
Contact information
Practice address
4 VILLAGE LOOP RD, B2, PHILLIPS RANCH, CA 91766-4891
(909) 620-0321
(909) 620-0324
Mailing address
4 VILLAGE LOOP RD, B2, PHILLIPS RANCH, CA 91766-4891
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
24452
CA
Other
Enumeration date
10/28/2008
Last updated
10/28/2008
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