Organization
DR. DEZA'S DENTAL OFFICE INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROCIO DEZA D.D.S (DENTIST/OWNER)
(951) 697-0909
Entity
Organization
Contact information
Practice address
23080 ALESSANDRO BLVD STE 201, MORENO VALLEY, CA 92553-9674
(951) 697-0909
(951) 697-1116
Mailing address
23080 ALESSANDRO BLVD STE 201, MORENO VALLEY, CA 92553-9674
(951) 697-0909
(951) 697-1116
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
43332
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1982707907
—
CA
Enumeration date
07/11/2016
Last updated
07/11/2016
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