Southland Dental Group Antoine Sourialle Dds
LBN: Southland Dental Group Antoine Sourialle Dds Inc
Southland Dental Group Antoine Sourialle Dds is an health care organization with primary practice located at 399 E Highland Ave Suite 120, San Bernardino CA 92404-3808. The organization recently has only one registered license in Dental Providers / General Practice, which is considered as the primary health care specialty.
Southland Dental Group Antoine Sourialle Dds Inc can be contacted via phone (909) 881-0645, or through Sourialle, Antoine O via phone (909) 881-0645.
Contact Information
Primary practice address
399 E Highland Ave Suite 120
San Bernardino CA 92404-3808
Phone: (909) 881-0645
Fax: (909) 881-4957
Website:
Authorized official contact:
Name: Sourialle, Antoine O Doctor of Dental Surgery (DDS)
Phone: (909) 881-0645
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / General Practice | 1223G0001X | 44093 | California |
Profile Details
| NPI number | 1588715031 |
|---|---|
| LBN Legal business name | Southland Dental Group Antoine Sourialle Dds Inc |
| DBA Doing business as | Southland Dental Group Antoine Sourialle Dds |
| Authorized official | Sourialle, Antoine O Doctor of Dental Surgery (DDS) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Jan 12th, 2007 |
| Last updated | Aug 22nd, 2020 - about 4 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1588715031 | NPPES |
| California | Other | 10490 | PACIFICARE HMO |
| California | Other | 20088156 | PACIFICARE HMO |
| California | Other | 004239 | PACIFICARE HMO |
| California | Other | B44093-01 | PACIFICARE HMO |
| California | Other | DJ61 | PACIFICARE HMO |
| California | Other | G92830-01 | PACIFICARE HMO |
| California | Other | 007367 | PACIFICARE HMO |
| California | Other | 50755-1 | PACIFICARE HMO |
| California | Other | 971330 | PACIFICARE HMO |
| California | Other | 97036530 | PACIFICARE HMO |
| California | Other | 134921 | PACIFICARE HMO |
| California | Other | F0275 | PACIFICARE HMO |
| California | Other | 0010973 | PACIFICARE HMO |
| California | Other | P006271 | PACIFICARE HMO |
| California | Other | 0004636 | PACIFICARE HMO |
| California | Other | 01628 | PACIFICARE HMO |
| California | Other | 210745 | PACIFICARE HMO |
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