Individual
JOSE E PONCE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
11275 PRICE DR, LOMA LINDA, CA 92354-4876
(909) 747-4133
Mailing address
11275 PRICE DR, LOMA LINDA, CA 92354-4876
(909) 747-4133
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
678
CA
Other
Enumeration date
03/09/2018
Last updated
03/09/2018
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