Provider Demographics
NPI:1659575579
Name:DR. AHUJA AND DR. GILL'S DENTAL OFFICE
Entity Type:Organization
Organization Name:DR. AHUJA AND DR. GILL'S DENTAL OFFICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:YOLANDA
Authorized Official - Middle Name:
Authorized Official - Last Name:PARADA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:909-885-3100
Mailing Address - Street 1:1584 W. BASELINE RD.
Mailing Address - Street 2:103
Mailing Address - City:SAN BERNARDINO
Mailing Address - State:CA
Mailing Address - Zip Code:92410
Mailing Address - Country:US
Mailing Address - Phone:909-885-3100
Mailing Address - Fax:909-885-0300
Practice Address - Street 1:1584 W. BASELINE RD.
Practice Address - Street 2:103
Practice Address - City:SAN BERNARDINO
Practice Address - State:CA
Practice Address - Zip Code:92410
Practice Address - Country:US
Practice Address - Phone:909-885-3100
Practice Address - Fax:909-885-0300
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty