Organization
LOMA LINDA UNIVERISTY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RODNEY DALE NEAL (VICE PRESIDENT)
(909) 558-4543
Entity
Organization
Contact information
Practice address
LOMA LINDA UNIVERSITY--SCHOOL OF DENTISTRY, 11092 ANDERSON STREET, LOMA LINDA, CA 92354
(909) 558-4613
(909) 558-4192
Mailing address
LOMA LINDA UNIVERSITY--SCHOOL OF DENTISTRY, 11092 ANDERSON STREET, LOMA LINDA, CA 92354
(909) 558-4613
(909) 558-4192
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
2043
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
G02000-01
—
CA
Enumeration date
01/02/2007
Last updated
03/18/2020
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