NPI | 1366862302 |
---|---|
Doing Business As | PLACERVILLE DENTISTRY GROUP |
Entity Type | Organization |
Authorized Contact | DEBRA KIDDER Manager 530-295-8000 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 54818) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CA 62434) |
Enumeration Date | 2014-04-17 |
Last Update Date | 2014-04-17 |