BROCKTON DENTAL X-RAY LAB., INC.; NPI #1467734491

Contact Information

BROCKTON DENTAL X-RAY LAB., INC.

6800 BROCKTON AVE STE 3
RIVERSIDE, CA 92506-3810

Phone: 951-682-7505
Fax: 951-682-7549
Website:

	Specialty	Taxonomy Code	Specialty Code	Provider Type
	Dental Laboratory	292200000X

Indicates primary specialty

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

NPI Number 1467734491

LBN Legal business name BROCKTON DENTAL X-RAY LAB., INC.

Authorized official MICHAEL CARPENTER - (OWNER)

Entity Organization

Organization subpart ¹ No

Enumeration date 09/15/2011

Last updated 09/15/2011 - About 15 years ago

Identifiers

CA	License #	RHP00050468
CA	License #	RHP7971

¹ Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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BROCKTON DENTAL X-RAY LAB., INC.

Contact Information

Specialty

Dental Laboratory

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

Reviews for BROCKTON DENTAL X-RAY LAB., INC.