Provider Demographics
NPI:1780030585
Name:VALUE DENTAL CENTERS MORENO VALLEY CA - RJ HOUCHIN DENTAL PRACTICE INC
Entity Type:Organization
Organization Name:VALUE DENTAL CENTERS MORENO VALLEY CA - RJ HOUCHIN DENTAL PRACTICE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:HOUCHIN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:909-576-3999
Mailing Address - Street 1:12721 MORENO BEACH DR
Mailing Address - Street 2:
Mailing Address - City:MORENO VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92555-4411
Mailing Address - Country:US
Mailing Address - Phone:951-692-7300
Mailing Address - Fax:951-485-7558
Practice Address - Street 1:12721 MORENO BEACH DR
Practice Address - Street 2:
Practice Address - City:MORENO VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92555-4411
Practice Address - Country:US
Practice Address - Phone:877-727-1258
Practice Address - Fax:951-485-7558
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-11
Last Update Date:2019-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA28166261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental