Organization
BOTOX FILLERS DERMATOLOGY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID OPAI-TETTEH MD (OWNER)
(424) 420-3461
Entity
Organization
Contact information
Practice address
10601 CHURCH ST STE 123, RANCHO CUCAMONGA, CA 91730-6840
(909) 321-8030
Mailing address
10601 CHURCH ST STE 123, RANCHO CUCAMONGA, CA 91730-6840
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
06/02/2025
Last updated
11/10/2025
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