Park Avenue Family Dentistry is a Dental Clinic in Pomona, California. It is located at 1087 N Park Ave, Pomona, CA and its contact number is 909-629-0201. The authorized person for Park Avenue Family Dentistry is Mr. Soedharsono Judo
who is Owner of the clinic and their contact number is 909-629-0201. The primary license number for Park Avenue Family Dentistry is 34127 (General Practice) in California. Park Avenue Family Dentistry Clinic caters to patients of all ages for their dental care needs. Dentists at the clinic are responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.
Complete Clinic Profile:
Park Avenue Family Dentistry Clinic speciality, address, contact phone number and fax are as below.
Patients can call on the below given phone number for appointments.
Name:
Park Avenue Family Dentistry
Specialization:
General Practice Dentistry
Clinic Address:
1087 N Park Ave, Pomona, California, 91768-3026
Phone:
909-629-0201
Authorized/Official Person Profile:
Officially authorized person to contact for any management issues or complaints for this clinic are as below. Person's position and contact details are also mentioned below.
Name:
Mr. Soedharsono Judo
Position:
Owner
Contact Number:
909-629-0201
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS).
NPI details for Park Avenue Family Dentistry clinic are as mentioned below.
NPI Number:
1205019858
NPI Enumeration Date:
06 Dec, 2007
NPI Last Update On:
06 Dec, 2007
Medical Licenses:
Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Park Avenue Family Dentistry are as mentioned below.
Specialization
License Number
State
Status
General Practice
34127
California
Primary
Other Medical Identifiers:
Other legacy medical identifiers of the clinic such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned as below.
Identifier
Type
State
Issuer
G9044501
Medicaid
California
Business Mailing Address:
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
Address:
Park Avenue Family Dentistry 1087 N Park Ave, Pomona, California
Zip:
91768-3026
Phone Number:
909-629-0201
Patients can reach Park Avenue Family Dentistry at 1087 N Park Ave, Pomona, California or can call to book an appointment on 909-629-0201. Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 11 November, 2024.