Provider Demographics
NPI:1275805996
Name:REBECCA S. AHLERS DDS DENTAL CORPORATION
Entity Type:Organization
Organization Name:REBECCA S. AHLERS DDS DENTAL CORPORATION
Other - Org Name:BRUCE J. UY D.M.D DENTAL CORPORATION
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:
Authorized Official - Last Name:AHLERS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:562-867-5191
Mailing Address - Street 1:16900 BELLFLOWER BLVD
Mailing Address - Street 2:STE 306
Mailing Address - City:BELLFLOWER
Mailing Address - State:CA
Mailing Address - Zip Code:90706
Mailing Address - Country:US
Mailing Address - Phone:562-867-5191
Mailing Address - Fax:562-925-6757
Practice Address - Street 1:16900 BELLFLOWER BLVD
Practice Address - Street 2:STE 306
Practice Address - City:BELLFLOWER
Practice Address - State:CA
Practice Address - Zip Code:90706
Practice Address - Country:US
Practice Address - Phone:562-867-5191
Practice Address - Fax:562-925-6757
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-27
Last Update Date:2020-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA360201223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty