| NPI | 1497447916 |
|---|---|
| Doing Business As | MACT DENTAL, MARIPOSA |
| Entity Type | Organization |
| Authorized Contact | JOHN SHAWVER ALEXANDER Executive Director 209-754-6258 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Additional Taxonomies | 171M00000X Case Manager/Care Coordinator |
| 261QD0000X Clinic/Center, Dental | |
| Enumeration Date | 2023-05-23 |
| Last Update Date | 2025-06-12 |