Organization Name: | ROSEMARIE CRISTINA P. REYES DDS INC. |
NPI Number: | 1013117993 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | ROSEMARIE CRISTINA PATRICIO REYES (CEO) |
Mailing Address: | 12602 Amargosa Rd Ste. D Victorville |
State: | CA US |
Postal Code: | 923927640 |
Phone Number: | 7602437701 |
Fax Number: | 7602432303 |
NPI Enumeration Date: | 07/19/2007 |
NPI Last Update Date: | 07/19/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QD0000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Dental |
Taxonomy Definition: |