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Organization
VILLAMOR R. USITA, D.D.S., INC.
Active
Organization
VILLAMOR R. USITA, D.D.S., INC.
Active
Other names
New Smile Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
DR. VILLAMOR RIALUBIN USITA D.D.S. (PRESIDENT DENTIST)
(909) 481-8881
Entity
Organization
Contact information
Practice address
11010 FOOTHILL BLVD, STE. 120, RANCHO CUCAMONGA, CA 91730-7616
(909) 481-8881
(909) 481-7722
Mailing address
11010 FOOTHILL BLVD, STE. 120, RANCHO CUCAMONGA, CA 91730-7616
(909) 481-8881
(909) 481-7722
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
43504
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1319695
UNITED CONCORDIA PROVIDER
CA
01
—
B43504-01
DENTI-CAL PROVIDER NUMBER
CA
Enumeration date
01/04/2007
Last updated
08/13/2007
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