Provider Demographics
NPI:1437398351
Name:C I DENTISTRY
Entity Type:Organization
Organization Name:C I DENTISTRY
Other - Org Name:CELIA INFANTE HERNANDEZ DENTAL CORPORATION
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CELIA
Authorized Official - Middle Name:
Authorized Official - Last Name:INFANTE HERNANDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:661-947-2400
Mailing Address - Street 1:38780 TRADE CENTER DR
Mailing Address - Street 2:1 B
Mailing Address - City:PALMDALE
Mailing Address - State:CA
Mailing Address - Zip Code:93551-3641
Mailing Address - Country:US
Mailing Address - Phone:661-947-2400
Mailing Address - Fax:661-947-1164
Practice Address - Street 1:38780 TRADE CENTER DR
Practice Address - Street 2:1 B
Practice Address - City:PALMDALE
Practice Address - State:CA
Practice Address - Zip Code:93551-3641
Practice Address - Country:US
Practice Address - Phone:661-947-2400
Practice Address - Fax:661-947-1164
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-17
Last Update Date:2009-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA452661223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty