Organization
VILLAGE DENTAL CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID O MEDINA DDS (PRESIDENT)
(951) 977-9991
Entity
Organization
Contact information
Practice address
10925 MAGNOLIA AVE, RIVERSIDE, CA 92505-3044
(951) 977-9991
(951) 588-8552
Mailing address
10925 MAGNOLIA AVE, RIVERSIDE, CA 92505-3044
(951) 977-9991
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
57425
CA
Other
Enumeration date
04/15/2014
Last updated
04/15/2014
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