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Organization
RITA DERAGOBIAN DDS INC
Active
Organization
RITA DERAGOBIAN DDS INC
Active
Other names
Glamour Dental Care
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RITA DERAGOBIAN DDS (OWNER)
(909) 399-3330
Entity
Organization
Contact information
Practice address
9509 CENTRAL AVE STE D, MONTCLAIR, CA 91763-2400
(909) 399-3330
Mailing address
9509 CENTRAL AVE STE D, MONTCLAIR, CA 91763-2400
(909) 399-3330
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
55480
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1578742953
NPI
CA
Enumeration date
01/09/2014
Last updated
01/09/2014
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