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Individual

DR. JOHN ROBERT BOTTALA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DDS, MS

Contact information

Practice address
3110 CHINO AVE, SUITE 200, CHINO HILLS, CA 91709-1211
(909) 613-9434
Mailing address
3110 CHINO AVE, SUITE 200, CHINO HILLS, CA 91709-1211
(909) 613-9434

Taxonomy

Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
35475
CA

Other

Enumeration date
05/07/2008
Last updated
05/07/2008
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