NPI 1467734491

Brockton Dental X-Ray Lab., INC.

Organisation Dental Laboratory Riverside, CA

Practice location

Address: 6800 Brockton Ave STE 3, Riverside, CA 92506-3810
Phone: (951) 682-7505
Fax: (951) 682-7549

Authorised official

Name: Michael W. Carpenter
Title: Owner
Phone: (951) 682-7505

Registered specialties (2)

Dental Laboratory Primary

Laboratories Taxonomy 292200000X Licence RHP00050468 (CA)

Other Dental Laboratory providers in California →

Dental Laboratory

Laboratories Taxonomy 292200000X Licence RHP7971 (CA)

Registry record

NPI: 1467734491
Entity type: Organization
NPI issued: 15 Sep 2011
Record last updated: 15 Sep 2011

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.