| Jack L. Semmens Dds Dental Corporation | |
|
495 No Lake Blvd Suite 270 Tahoe City CA 96145 | |
| (530) 583-5546 | |
| Not Available |
| Full Name | Jack L. Semmens Dds Dental Corporation |
|---|---|
| Speciality | Dentist |
| Location | 495 No Lake Blvd, Tahoe City, California |
| Authorized Official Name and Position | Jack L. Semmens (PRESIDENT) |
| Authorized Official Contact | 5305835546 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Jack L. Semmens Dds Dental Corporation 495 No Lake Blvd, - P.o. Box 1912 Suite 270 Tahoe City CA 96145 Ph: (530) 583-5546 | Jack L. Semmens Dds Dental Corporation 495 No Lake Blvd Suite 270 Tahoe City CA 96145 Ph: (530) 583-5546 |
| NPI Number | 1134430325 |
|---|---|
| Provider Enumeration Date | 06/23/2010 |
| Last Update Date | 06/23/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134430325 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 18407 (California) | Primary |
Tahoe City Dental Group Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 140 Mackinaw St, Tahoe City, CA 96145 Phone: 530-583-0278 Fax: 530-583-8660 | |
Jack L. Semmens Dds Dental Corporation Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 495 No Lake Blvd,, Tahoe City, CA 96145 Phone: 530-583-5546 |