Provider Demographics
NPI:1417506932
Name:RINCON DDS AND ASSOCIATES INC
Entity type:Organization
Organization Name:RINCON DDS AND ASSOCIATES INC
Other - Org Name:
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:DDS
Authorized Official - Phone:760-256-6600
Mailing Address - Street 1:1078 E HOSPITALITY LN
Mailing Address - Street 2:
Mailing Address - City:SAN BERNARDINO
Mailing Address - State:CA
Mailing Address - Zip Code:92408-2878
Mailing Address - Country:US
Mailing Address - Phone:760-256-6600
Mailing Address - Fax:760-256-6699
Practice Address - Street 1:1078 E HOSPITALITY LN
Practice Address - Street 2:
Practice Address - City:SAN BERNARDINO
Practice Address - State:CA
Practice Address - Zip Code:92408-2878
Practice Address - Country:US
Practice Address - Phone:909-799-8200
Practice Address - Fax:909-799-8299
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ALBERT DDS AND ASSOCIATES INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-09-06
Last Update Date:2020-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty