Provider Demographics
NPI:1750565701
Name:PEOPLE'S DENTAL
Entity type:Organization
Organization Name:PEOPLE'S DENTAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MAGDALENA
Authorized Official - Middle Name:
Authorized Official - Last Name:CERVANTES GARCIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:760-353-5100
Mailing Address - Street 1:2387 US HWY 86
Mailing Address - Street 2:
Mailing Address - City:IMPERIAL
Mailing Address - State:CA
Mailing Address - Zip Code:92227
Mailing Address - Country:US
Mailing Address - Phone:760-353-5100
Mailing Address - Fax:760-353-0576
Practice Address - Street 1:2387 US HIGHWAY 86
Practice Address - Street 2:
Practice Address - City:IMPERIAL
Practice Address - State:CA
Practice Address - Zip Code:92251-9780
Practice Address - Country:US
Practice Address - Phone:760-353-5100
Practice Address - Fax:760-353-0576
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PEOPLE'S DENTAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-12-27
Last Update Date:2007-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty