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DR. JOHN ROBERT BOTTALA DDS, MS
Orthodontics and Dentofacial Orthopedics >> Dentist >> Dental ProvidersRegistrant NPI Number: 1639345861
Individual Registrant:DR. JOHN ROBERT BOTTALA DDS, MS
Gender: M
Sole Proprietor
Gender: M
Sole Proprietor
Location and contact information for practice:
3110 CHINO AVE SUITE 200 CHINO HILLS, CA 91709-1211 US
Tel: 909-613-9434 Fax: --
Tel: 909-613-9434 Fax: --
Contact information for business:
3110 CHINO AVE SUITE 200 CHINO HILLS, CA 91709-1211 US
Tel: 909-613-9434 Fax: --
Tel: 909-613-9434 Fax: --
Registration Information:
NPI: 1639345861
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 1223X0400X | Dental Providers Dentist Orthodontics and Dentofacial Orthopedics | CA | 35475 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
