| Stadium Dental And Orthodontics | |
|
11897 Foothill Blvd Suite A Rancho Cucamonga CA 91730 | |
| (909) 476-9678 | |
| (909) 481-0040 |
| Full Name | Stadium Dental And Orthodontics |
|---|---|
| Speciality | Dentist |
| Location | 11897 Foothill Blvd, Rancho Cucamonga, California |
| Authorized Official Name and Position | Sekhar N Chakka (OWNER DENTIST) |
| Authorized Official Contact | 9094769678 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Stadium Dental And Orthodontics 11897 Foothill Blvd Suite A Rancho Cucamonga CA 91730 Ph: (909) 476-9678 | Stadium Dental And Orthodontics 11897 Foothill Blvd Suite A Rancho Cucamonga CA 91730 Ph: (909) 476-9678 |
| NPI Number | 1093959207 |
|---|---|
| Provider Enumeration Date | 05/01/2009 |
| Last Update Date | 10/21/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093959207 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 47856 (California) | Primary |
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