Provider Demographics
NPI:1891123196
Name:INLAND DENTAL CENTER HIGHLAND
Entity Type:Organization
Organization Name:INLAND DENTAL CENTER HIGHLAND
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:QUINTIN
Authorized Official - Last Name:BOYD
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:909-862-2121
Mailing Address - Street 1:6982 BOULDER AVE
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND
Mailing Address - State:CA
Mailing Address - Zip Code:92346-3328
Mailing Address - Country:US
Mailing Address - Phone:909-862-2121
Mailing Address - Fax:909-862-6648
Practice Address - Street 1:6982 BOULDER AVE
Practice Address - Street 2:
Practice Address - City:HIGHLAND
Practice Address - State:CA
Practice Address - Zip Code:92346-3328
Practice Address - Country:US
Practice Address - Phone:909-862-2121
Practice Address - Fax:909-862-6648
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-23
Last Update Date:2013-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA38650305R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305R00000XManaged Care OrganizationsPreferred Provider Organization