Fresh Leaf Dental

LBN: Ksl Dental Group Inc
Fresh Leaf Dental is an health care organization with primary practice located at 815 W Holt Blvd Ste 402 , Ontario CA 91762-3681. The organization recently has 2 registered licenses in different health care specialties including Dental Providers / Dentist, Ambulatory Health Care Facilities / Dental. Dental Providers / Dentist is the primary health care specialty. Ksl Dental Group Inc can be contacted via phone (972) 746-0881, or through Amer, Nevein via phone (972) 746-0881.

Contact Information

Primary practice address
815 W Holt Blvd Ste 402 Ontario CA 91762-3681
Phone: (972) 746-0881
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Amer, Nevein Doctor of Dental Surgery (DDS)
Phone: (972) 746-0881

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Dentist 122300000X 47881 California
Ambulatory Health Care Facilities / Dental 261QD0000X

Profile Details

NPI number 1033592241
LBN Legal business name Ksl Dental Group Inc
DBA Doing business as Fresh Leaf Dental
Authorized official Amer, Nevein Doctor of Dental Surgery (DDS)
Entity Organization
Organization subpart 1 No
Enumeration date Jul 7th, 2015
Last updated Dec 6th, 2022 - about 3 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1033592241 NPPES
California Other 47881 DDS

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