Provider Demographics
NPI:1629576608
Name:ALVAREZ & BERNARDO DENTAL CORPORATION
Entity Type:Organization
Organization Name:ALVAREZ & BERNARDO DENTAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER/DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:SERAFIN
Authorized Official - Middle Name:LABAO
Authorized Official - Last Name:BERNARDO
Authorized Official - Suffix:JR
Authorized Official - Credentials:DDS
Authorized Official - Phone:909-422-0885
Mailing Address - Street 1:PO BOX 520
Mailing Address - Street 2:
Mailing Address - City:COLTON
Mailing Address - State:CA
Mailing Address - Zip Code:92324-0520
Mailing Address - Country:US
Mailing Address - Phone:909-422-0885
Mailing Address - Fax:909-422-0890
Practice Address - Street 1:1200 E WASHINGTON ST STE F2
Practice Address - Street 2:
Practice Address - City:COLTON
Practice Address - State:CA
Practice Address - Zip Code:92324-6499
Practice Address - Country:US
Practice Address - Phone:909-422-0885
Practice Address - Fax:909-422-0890
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ALVAREZ & BERNARDO DENTAL CORPORATIO
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-01-25
Last Update Date:2018-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA377881223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty