Provider Demographics
NPI:1326408261
Name:ALLURE DENTAL
Entity Type:Organization
Organization Name:ALLURE DENTAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RAJESH
Authorized Official - Middle Name:M
Authorized Official - Last Name:SHAH
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:951-280-9300
Mailing Address - Street 1:1353 W MILL ST
Mailing Address - Street 2:SUITE 114
Mailing Address - City:SAN BERNARDINO
Mailing Address - State:CA
Mailing Address - Zip Code:92410-2223
Mailing Address - Country:US
Mailing Address - Phone:909-567-2024
Mailing Address - Fax:909-453-0889
Practice Address - Street 1:1353 W MILL ST
Practice Address - Street 2:
Practice Address - City:SAN BERNARDINO
Practice Address - State:CA
Practice Address - Zip Code:92410-2244
Practice Address - Country:US
Practice Address - Phone:909-567-2024
Practice Address - Fax:909-453-0889
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-04
Last Update Date:2016-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA46135122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty