Provider Demographics
NPI:1235023540
Name:RANCHO DENTISTRY
Entity type:Organization
Organization Name:RANCHO DENTISTRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:VINCENT
Authorized Official - Middle Name:
Authorized Official - Last Name:GOYMERAC
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:909-944-2800
Mailing Address - Street 1:8215 ROCHESTER AVE STE 102
Mailing Address - Street 2:
Mailing Address - City:RANCHO CUCAMONGA
Mailing Address - State:CA
Mailing Address - Zip Code:91730-0727
Mailing Address - Country:US
Mailing Address - Phone:909-944-2800
Mailing Address - Fax:909-944-3662
Practice Address - Street 1:8215 ROCHESTER AVE STE 102
Practice Address - Street 2:
Practice Address - City:RANCHO CUCAMONGA
Practice Address - State:CA
Practice Address - Zip Code:91730-0727
Practice Address - Country:US
Practice Address - Phone:909-944-2800
Practice Address - Fax:909-944-3662
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-06-03
Last Update Date:2025-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty