| Foothill Dental | |
|
21911 Foothill Blvd Hayward CA 94541-2118 | |
| (510) 733-1455 | |
| (510) 889-8395 |
| Full Name | Foothill Dental |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 21911 Foothill Blvd, Hayward, California |
| Authorized Official Name and Position | Clelen C. Tanner (OWNER) |
| Authorized Official Contact | 5107331455 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Foothill Dental 21911 Foothill Blvd Hayward CA 94541-2118 Ph: (510) 733-1455 | Foothill Dental 21911 Foothill Blvd Hayward CA 94541-2118 Ph: (510) 733-1455 |
| NPI Number | 1689991762 |
|---|---|
| Provider Enumeration Date | 04/28/2010 |
| Last Update Date | 04/28/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689991762 | NPI | - | NPPES |
| 1215080445 | Other | CA | NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 26003 (California) | Primary |
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