Organization
ANKIN DERAGOBIAN D.D.S. INC.
Active
Other names
Golden Smiles Dental
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANKIN DERAGOBIAN DDS (OWNER/PRESIDENT)
(909) 481-8990
Entity
Organization
Contact information
Practice address
9635 MILLIKEN AVE STE 103, RANCHO CUCAMONGA, CA 91730-9004
(909) 481-8990
(909) 481-8875
Mailing address
9635 MILLIKEN AVE STE 103, RANCHO CUCAMONGA, CA 91730-9004
(909) 481-8990
(909) 481-8875
Taxonomy
Speciality
Code
Description
License number
State
302F00000X
Exclusive Provider Organization
Primary
59757
CA
Other
Enumeration date
08/22/2014
Last updated
01/28/2015
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