Provider Demographics
NPI:1508006586
Name:F.H. BANEZ DENTAL CORPORATION
Entity Type:Organization
Organization Name:F.H. BANEZ DENTAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:FELIZA
Authorized Official - Middle Name:HELEN
Authorized Official - Last Name:BANEZ
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:909-792-0500
Mailing Address - Street 1:2094 W REDLANDS BLVD STE F
Mailing Address - Street 2:
Mailing Address - City:REDLANDS
Mailing Address - State:CA
Mailing Address - Zip Code:92373-6266
Mailing Address - Country:US
Mailing Address - Phone:909-792-0500
Mailing Address - Fax:909-792-0598
Practice Address - Street 1:2094 W REDLANDS BLVD STE F
Practice Address - Street 2:
Practice Address - City:REDLANDS
Practice Address - State:CA
Practice Address - Zip Code:92373-6266
Practice Address - Country:US
Practice Address - Phone:909-792-0500
Practice Address - Fax:909-792-0598
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-03
Last Update Date:2015-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA50569261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental