| Dentrust, P.c. | |
|
461 Skymaster Cir Bldg 648 Travis Afb CA 94535-1909 | |
| (707) 474-4599 | |
| (707) 402-6535 |
| Full Name | Dentrust, P.c. |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 461 Skymaster Cir Bldg 648, Travis Afb, California |
| Authorized Official Name and Position | Amanda Evans Lance (CREDENTIALING SPECIALIST) |
| Authorized Official Contact | 9107289767 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dentrust, P.c. 461 Skymaster Cir Bldg 648 Travis Afb CA 94535-1909 Ph: (707) 474-4599 | Dentrust, P.c. 461 Skymaster Cir Bldg 648 Travis Afb CA 94535-1909 Ph: (707) 474-4599 |
| NPI Number | 1124763271 |
|---|---|
| Provider Enumeration Date | 05/03/2022 |
| Last Update Date | 09/01/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124763271 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
United States Air Force Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 101 Bodin Cir, Travis Afb, CA 94535 Phone: 707-423-7008 |