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Organization
JS LID DDS, INC.
Active
Organization
JS LID DDS, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHNNY LID DDS (PRESIDENT)
(676) 320-3611
Entity
Organization
Contact information
Practice address
9791 BASELINE RD., RANCHO CUCAMONGA, CA 91730
(909) 987-8779
(909) 987-2815
Mailing address
9791 BASELINE RD., RANCHO CUCAMONGA, CA 91730
(909) 987-8779
(909) 987-2815
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
51966
CA
Other
Enumeration date
03/11/2015
Last updated
03/11/2015
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