Provider Demographics
NPI:1992953806
Name:FLORES, SOBERO & YABAR DENTAL CORP
Entity type:Organization
Organization Name:FLORES, SOBERO & YABAR DENTAL CORP
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ROCIO
Authorized Official - Middle Name:
Authorized Official - Last Name:ZURITA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:951-601-0350
Mailing Address - Street 1:24430 ALESSANDRO BLVD
Mailing Address - Street 2:SUITE 104
Mailing Address - City:MORENO VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92553-2435
Mailing Address - Country:US
Mailing Address - Phone:951-601-0350
Mailing Address - Fax:951-601-0325
Practice Address - Street 1:24430 ALESSANDRO BLVD
Practice Address - Street 2:SUITE 104
Practice Address - City:MORENO VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92553-2435
Practice Address - Country:US
Practice Address - Phone:951-601-0350
Practice Address - Fax:951-601-0325
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FLORES, SOBERO & YABAR DENTAL CORP
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-09-04
Last Update Date:2008-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA435091223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty