| Dental Source of California | |
|
930 Florin Rd Ste 104 Sacramento CA 95831-5002 | |
| (916) 421-2424 | |
| Not Available |
| Full Name | Dental Source of California |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 930 Florin Rd Ste 104, Sacramento, California |
| Authorized Official Name and Position | Donald E Clarke (CORPORATION PRESIDENT) |
| Authorized Official Contact | 9164870117 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dental Source of California 930 Florin Rd Ste 104 Sacramento CA 95831-5002 Ph: (916) 421-2424 | Dental Source of California 930 Florin Rd Ste 104 Sacramento CA 95831-5002 Ph: (916) 421-2424 |
| NPI Number | 1205434396 |
|---|---|
| Provider Enumeration Date | 10/12/2020 |
| Last Update Date | 10/12/2020 |
| Certification Date | 10/12/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205434396 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (NU) | Primary |
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