Provider Demographics
NPI:1386937753
Name:MARCELO TOLEDO DDS INC
Entity type:Organization
Organization Name:MARCELO TOLEDO DDS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MARCELO
Authorized Official - Middle Name:GABRIEL
Authorized Official - Last Name:TOLEDO
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:909-319-3600
Mailing Address - Street 1:326 N RIVERSIDE AVE
Mailing Address - Street 2:
Mailing Address - City:RIALTO
Mailing Address - State:CA
Mailing Address - Zip Code:92376-5926
Mailing Address - Country:US
Mailing Address - Phone:909-875-1464
Mailing Address - Fax:909-875-1467
Practice Address - Street 1:326 N RIVERSIDE AVE
Practice Address - Street 2:
Practice Address - City:RIALTO
Practice Address - State:CA
Practice Address - Zip Code:92376-5926
Practice Address - Country:US
Practice Address - Phone:909-875-1464
Practice Address - Fax:909-875-1467
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-18
Last Update Date:2024-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA54668122300000X
261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental
No122300000XDental ProvidersDentistGroup - Single Specialty