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Organization
HOSPITALITY DENTAL GROUP INC
Active
Organization
HOSPITALITY DENTAL GROUP INC
Active
Other names
Hospitality Dental & Orthodontics
Organization subpart
No
Provider details
NPI number
Authorized official
JOSUE MORAN (DIRECTOR OF ADMINISTRATIVE SERVICES)
(909) 723-1044
Entity
Organization
Contact information
Practice address
164 W HOSPITALITY LN STE 14, SAN BERNARDINO, CA 92408-3329
(909) 888-7817
(909) 495-1315
Mailing address
PO BOX 10669, SAN BERNARDINO, CA 92423-0669
(909) 723-1044
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NA
N/A
—
Enumeration date
09/05/2019
Last updated
06/30/2026
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