Provider Demographics
NPI:1679916233
Name:MOBILIA DENTAL CORPORATION
Entity Type:Organization
Organization Name:MOBILIA DENTAL CORPORATION
Other - Org Name:ARROW FAMILY DENTISTRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ADRIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:MOBILIA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:760-333-1859
Mailing Address - Street 1:10064 ARROW RTE
Mailing Address - Street 2:
Mailing Address - City:RANCHO CUCAMONGA
Mailing Address - State:CA
Mailing Address - Zip Code:91730-4194
Mailing Address - Country:US
Mailing Address - Phone:909-987-5522
Mailing Address - Fax:909-987-5532
Practice Address - Street 1:10064 ARROW RTE
Practice Address - Street 2:
Practice Address - City:RANCHO CUCAMONGA
Practice Address - State:CA
Practice Address - Zip Code:91730-4194
Practice Address - Country:US
Practice Address - Phone:909-987-5522
Practice Address - Fax:909-987-5532
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-14
Last Update Date:2013-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA57213261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental