Provider Demographics
NPI:1003099425
Name:DHAMA AND RODGERS DENTAL CORPORATION
Entity type:Organization
Organization Name:DHAMA AND RODGERS DENTAL CORPORATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:DEEPIKA
Authorized Official - Middle Name:
Authorized Official - Last Name:DHAMA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:951-808-5881
Mailing Address - Street 1:2860 MICHELLE FL 2
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92606-1008
Mailing Address - Country:US
Mailing Address - Phone:714-508-3600
Mailing Address - Fax:714-368-2092
Practice Address - Street 1:6445 PAT'S RANCH ROAD
Practice Address - Street 2:STE G
Practice Address - City:MIRA LOMA
Practice Address - State:CA
Practice Address - Zip Code:91752
Practice Address - Country:US
Practice Address - Phone:951-808-5881
Practice Address - Fax:951-278-9240
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-07
Last Update Date:2007-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty