| Civic Center Dental | |
|
39370 Civic Center Dr Suite D Fremont CA 94538-6716 | |
| (510) 793-5033 | |
| (510) 793-5133 |
| Full Name | Civic Center Dental |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 39370 Civic Center Dr, Fremont, California |
| Authorized Official Name and Position | Mitchell Tancio (DENTIST/OWNER) |
| Authorized Official Contact | 5107935033 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Civic Center Dental 39370 Civic Center Dr Suite D Fremont CA 94538-6716 Ph: (510) 793-5033 | Civic Center Dental 39370 Civic Center Dr Suite D Fremont CA 94538-6716 Ph: (510) 793-5033 |
| NPI Number | 1205005436 |
|---|---|
| Provider Enumeration Date | 02/21/2008 |
| Last Update Date | 02/21/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205005436 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 40889 (California) | Primary |
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