Organization
JORGE L. GERONIMO, DDS PROF. DENTAL CORP.
Active
Parent organization
PACIFIC DENTAL CLINIC
Organization subpart
Yes
Provider details
NPI number
Legal business name
PACIFIC DENTAL CLINIC
Authorized official
JORGE LUIS GERONIMO DDS (DENTIST)
(714) 267-6400
Entity
Organization
Contact information
Practice address
9720 MAGNOLIA AVE SUITE #100, RIVERSIDE, CA 92503
(951) 696-3663
(951) 696-3887
Mailing address
9720 MAGNOLIA AVE SUITE 100, RIVERSIDE, CA 92503
(951) 696-3663
(951) 696-3887
Taxonomy
Speciality
Code
Description
License number
State
305R00000X
Preferred Provider Organization
Primary
47897
CA
Other
Enumeration date
08/27/2015
Last updated
01/03/2020
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