Sorours Dental Office Corporation
Dentist in Fontana, CA. Organization (NPI-2).
NPI number1528831781
StatusActive
Last updated in NPPESOct 31, 2023
Details
- NPI
- 1528831781
- Entity type
- Organization (NPI-2)
- Legal business name
- Sorours Dental Office Corporation
- Organization subpart
- No
- Enumeration date
- Oct 31, 2023
- Certification date
- Oct 31, 2023
- Last updated
- Oct 31, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 122300000X | Dentist | – | – | Yes |
Practice location
17185 Arrow BlvdFontana, CA 92335-3972
Phone 909-587-2474 · Fax 909-365-4358
Mailing address
6633 Atlantic AveBell, CA 90201-2523
Phone 323-456-7377
Authorized official
Selvana Sorour
Vice President
3107953363
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