Provider Demographics
NPI:1932554540
Name:VALUE DENTAL CENTERS CHINO CA - R J HOUCHIN DENTAL PRACTICE INC
Entity Type:Organization
Organization Name:VALUE DENTAL CENTERS CHINO CA - R J HOUCHIN DENTAL PRACTICE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:TRACY
Authorized Official - Middle Name:H
Authorized Official - Last Name:TRAN
Authorized Official - Suffix:
Authorized Official - Credentials:MBA/MPH
Authorized Official - Phone:877-727-1258
Mailing Address - Street 1:3943 GRAND AVE
Mailing Address - Street 2:
Mailing Address - City:CHINO
Mailing Address - State:CA
Mailing Address - Zip Code:91710-5440
Mailing Address - Country:US
Mailing Address - Phone:877-727-1258
Mailing Address - Fax:951-485-7558
Practice Address - Street 1:3943 GRAND AVE
Practice Address - Street 2:
Practice Address - City:CHINO
Practice Address - State:CA
Practice Address - Zip Code:91710-5440
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:2016-05-02
Last Update Date:2016-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA28166261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental