| Jefferson Dental | |
|
79800 Highway 111 Ste 109 La Quinta CA 92253-6003 | |
| (760) 775-0600 | |
| (760) 775-0663 |
| Full Name | Jefferson Dental |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 79800 Highway 111 Ste 109, La Quinta, California |
| Authorized Official Name and Position | Syeda Shabnam Huq (OWNER) |
| Authorized Official Contact | 7607750600 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Jefferson Dental 79800 Highway 111 Ste 109 La Quinta CA 92253-6003 Ph: (760) 775-0600 | Jefferson Dental 79800 Highway 111 Ste 109 La Quinta CA 92253-6003 Ph: (760) 775-0600 |
| NPI Number | 1154638500 |
|---|---|
| Provider Enumeration Date | 09/07/2010 |
| Last Update Date | 09/07/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154638500 | NPI | - | NPPES |
| 1861669533 | Medicaid | CA | |
| 1861612954 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 56971 (California) | Secondary |
| 1223G0001X | Dentist - General Practice | 44484 (California) | Primary |
Larry Kunkle, Dds, Apc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 78640 Highway 111, La Quinta, CA 92253 Phone: 760-564-0955 | |
Huq Dds Inc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 79800 Highway 111 Ste 109, La Quinta, CA 92253 Phone: 760-775-0600 Fax: 760-775-0663 | |
Caleo Bay Orthodontics Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 47875 Caleo Bay Dr, A101, La Quinta, CA 92253 Phone: 760-564-1300 | |
Bright Now Dental - La Quinta Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 79255 Highway 111, Suite 1a & 1b, La Quinta, CA 92253 Phone: 760-771-1200 Fax: 760-564-6370 | |
Rita Christine Soto Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 78900 Avenue 47, Ste. 110, La Quinta, CA 92253 Phone: 760-771-8334 Fax: 760-771-8337 | |
Dental Del Desierto Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 50855 Washington St, Suite 2g, La Quinta, CA 92253 Phone: 760-234-6497 |