SAN GABRIEL VALLEY FOUNDATION FOR DENTAL HEALTH NPI 1700189495

NPI Information

SAN GABRIEL VALLEY FOUNDATION FOR DENTAL HEALTH is a pediatric dentistry dentist in La Puente, CA. The provider is an age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. SAN GABRIEL VALLEY FOUNDATION FOR DENTAL HEALTH NPI is 1700189495. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

14101 NELSON AVE
LA PUENTE, CA
ZIP 91746-640
Phone: (626) 688-6407
Fax: (626) 934-2893

The provider's authorized official is Sondra Contino .
The authorized official title is Director and has the following contact phone number (626) 688-6407.

The CLIA number assigned to this NPI record is 05D2122594 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 12/18/2010 and was last updated on 12/18/2010.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

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