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Organization
FELDKAMP CAL SELECT DENTAL GROUP, INC.
Active
Organization
FELDKAMP CAL SELECT DENTAL GROUP, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. IRVING MOORE FELDKAMP III DDS (OWNER)
(909) 332-6980
Entity
Organization
Contact information
Practice address
8325 HAVEN AVE STE 120, RANCHO CUCAMONGA, CA 91730-3894
(909) 332-6980
Mailing address
PO BOX 10669, SAN BERNARDINO, CA 92423-0669
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1982016838
—
CA
Enumeration date
06/25/2020
Last updated
09/08/2020
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