Provider Demographics
NPI:1467669028
Name:A & T SANTOS DENTAL CORPORATION
Entity type:Organization
Organization Name:A & T SANTOS DENTAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ALEXANDER
Authorized Official - Middle Name:GUZMAN
Authorized Official - Last Name:SANTOS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:909-393-5300
Mailing Address - Street 1:4183 CHINO HILLS PKWY
Mailing Address - Street 2:SUITE H
Mailing Address - City:CHINO HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91709-3781
Mailing Address - Country:US
Mailing Address - Phone:909-393-5300
Mailing Address - Fax:
Practice Address - Street 1:4183 CHINO HILLS PKWY
Practice Address - Street 2:SUITE H
Practice Address - City:CHINO HILLS
Practice Address - State:CA
Practice Address - Zip Code:91709-3781
Practice Address - Country:US
Practice Address - Phone:909-393-5300
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-16
Last Update Date:2011-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA35987261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA35987OtherDENTIST LICENSE