Organization
SAUCEDO DETAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SERGIO P SAUCEDO DDS (CEO)
(909) 623-5278
Entity
Organization
Contact information
Practice address
180 E MISSION BLVD STE A, POMONA, CA 91766-1843
(909) 623-5278
(909) 623-5270
Mailing address
180 E MISSION BLVD STE A, POMONA, CA 91766-1843
(909) 623-5278
(909) 623-5270
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
56687
CA
Other
Enumeration date
04/28/2011
Last updated
04/28/2011
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