Provider Demographics
NPI:1285292573
Name:ALBERT RINCON DDS AND ASSOCIATES INC.
Entity type:Organization
Organization Name:ALBERT RINCON DDS AND ASSOCIATES INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ALBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:RINCON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:760-256-6600
Mailing Address - Street 1:1352 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:BARSTOW
Mailing Address - State:CA
Mailing Address - Zip Code:92311-3220
Mailing Address - Country:US
Mailing Address - Phone:760-256-6600
Mailing Address - Fax:760-256-6606
Practice Address - Street 1:1352 E MAIN ST
Practice Address - Street 2:
Practice Address - City:BARSTOW
Practice Address - State:CA
Practice Address - Zip Code:92311-3220
Practice Address - Country:US
Practice Address - Phone:760-256-6600
Practice Address - Fax:760-256-6606
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-31
Last Update Date:2020-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty