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Organization

DENTAL DEPOT

Active
Parent organization
EDWARD H. GRUBER DDS
Organization subpart
Yes

Provider details

NPI number
Legal business name
EDWARD H. GRUBER DDS
Authorized official
MRS. MYRNA VELASQUEZ (OFFICE MANAGER)
(661) 871-3736
Entity
Organization

Contact information

Practice address
4022 NILES ST, BAKERSFIELD, CA 93306-4630
(661) 871-3736
(661) 871-7417
Mailing address
4022 NILES ST, BAKERSFIELD, CA 93306-4630
(661) 871-3736
(661) 871-7417

Taxonomy

Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
33020
CA

Other

Enumeration date
09/16/2009
Last updated
09/16/2009
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