Provider Demographics
NPI:1124840467
Name:PATRICIA ANN POMPA, D.D.S., INC.
Entity type:Organization
Organization Name:PATRICIA ANN POMPA, D.D.S., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:POMPA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:909-874-3210
Mailing Address - Street 1:1723 N RIVERSIDE AVE
Mailing Address - Street 2:
Mailing Address - City:RIALTO
Mailing Address - State:CA
Mailing Address - Zip Code:92376-8062
Mailing Address - Country:US
Mailing Address - Phone:909-874-3210
Mailing Address - Fax:909-874-3802
Practice Address - Street 1:1723 N RIVERSIDE AVE
Practice Address - Street 2:
Practice Address - City:RIALTO
Practice Address - State:CA
Practice Address - Zip Code:92376-8062
Practice Address - Country:US
Practice Address - Phone:909-874-3210
Practice Address - Fax:909-874-3802
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-28
Last Update Date:2024-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental
No1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Multi-Specialty