National Provider Identifier Database

BROCKTON DENTAL X RAY LAB INC
Dental Laboratory

A commercial laboratory specializing in the construction of dental appliances that conform to a dentist?s specifications including the construction of dentures (complete or partial), orthodontic appliances, bridgework, crowns, and inlays.


Contact Information

BROCKTON DENTAL X-RAY LAB., INC.
6800 BROCKTON AVE STE 3
RIVERSIDE, CA92506-3810
Phone: 951-682-7505
Fax: 951-682-7549
Website:
Specialty Taxonomy Code
* Dental Laboratory 292200000X

* Indicates primary specialty

NPI Profile & details for BROCKTON DENTAL X-RAY LAB., INC.

NPI Number 1467734491
Legal business name
LBN
BROCKTON DENTAL X-RAY LAB., INC.
Authorized official MICHAEL CARPENTER - (OWNER)
Entity Organization
Organization subpart No
Enumeration date 09/15/2011
Last updated 09/15/2011 - About 15 years ago
Sole proprietor1 Not specified
Identifiers
  • CA License #: RHP00050468
  • CA License #: RHP7971

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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