Organization
RANCHO DENTAL OFFICE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. FERNANDO J VILLARROEL DDS (OWNER)
(909) 421-1555
Entity
Organization
Contact information
Practice address
2010 N RIVERSIDE AVE, SUITE A, RIALTO, CA 92377-4652
(909) 421-1555
(909) 421-1865
Mailing address
2010 N RIVERSIDE AVE, SUITE A, RIALTO, CA 92377-4652
(909) 421-1555
(909) 421-1865
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
44377
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
G93878-01
DENTICAL
CA
Enumeration date
09/10/2007
Last updated
09/10/2007
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