Provider Demographics
NPI:1447801600
Name:ROWENA GBENOBA A DENTAL CORPORATION
Entity Type:Organization
Organization Name:ROWENA GBENOBA A DENTAL CORPORATION
Other - Org Name:FRENCH VALLEY DENTAL GROUP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROWENA
Authorized Official - Middle Name:
Authorized Official - Last Name:GBENOBA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:951-325-7776
Mailing Address - Street 1:30688 BENTON RD STE B102
Mailing Address - Street 2:
Mailing Address - City:WINCHESTER
Mailing Address - State:CA
Mailing Address - Zip Code:92596-8469
Mailing Address - Country:US
Mailing Address - Phone:951-325-7776
Mailing Address - Fax:951-325-7737
Practice Address - Street 1:30688 BENTON RD STE B102
Practice Address - Street 2:
Practice Address - City:WINCHESTER
Practice Address - State:CA
Practice Address - Zip Code:92596-8469
Practice Address - Country:US
Practice Address - Phone:951-325-7776
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-27
Last Update Date:2020-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty