| NPI | 1538181557 |
|---|---|
| Other Name | SHASTA COMMUNITY DENTAL CLINIC |
| Entity Type | Organization |
| Authorized Contact | JEFFERY BRANDON THORNOCK CEO 530-246-5710 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: CA 230000297) |
| Enumeration Date | 2006-07-25 |
| Last Update Date | 2024-10-14 |