# DR. SAMUEL'S DENTAL GROUP, INC.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1679865778
- **Authorized official:** DR. NAVEEN SAMUEL D.D.S. (PRESIDENT)
- **Authorized official phone:** (909) 844-6866

## Contact information

- **Practice address:** 6860 BROCKTON AVE STE 10, RIVERSIDE, CA 92506-3816
- **Practice address phone:** (951) 683-5225
- **Mailing address:** 71949 HIGHWAY 111 STE 100, RANCHO MIRAGE, CA 92270-4826
- **Mailing address phone:** (909) 844-6866

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 51299 | CA | Yes |

## Other

- **Enumeration date:** 05/06/2011
- **Last updated:** 05/06/2011