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DR. JOHN ROBERT BOTTALA DDS, MS

Orthodontics and Dentofacial Orthopedics >> Dentist >> Dental Providers

Registrant NPI Number: 1639345861

Individual Registrant:
DR. JOHN ROBERT BOTTALA DDS, MS
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: --

Contact information for business:
3110 CHINO AVE SUITE 200 CHINO HILLS, CA 91709-1211 US
Tel: 909-613-9434  Fax: --

Registration Information:
NPI: 1639345861
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y1223X0400XDental Providers
Dentist
Orthodontics and Dentofacial Orthopedics
CA35475

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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