| Nova Teledentistry | |
|
8111 Aztec Way Antelope CA 95843-4411 | |
| (916) 540-0737 | |
| Not Available |
| Full Name | Nova Teledentistry |
|---|---|
| Speciality | Dentist - Dental Public Health |
| Location | 8111 Aztec Way, Antelope, California |
| Authorized Official Name and Position | Roxanne Roccanova (FOUNDER) |
| Authorized Official Contact | 9165400737 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Nova Teledentistry 7451 Auburn Blvd Ste C Citrus Heights CA 95610-2992 | Nova Teledentistry 8111 Aztec Way Antelope CA 95843-4411 Ph: (916) 540-0737 |
| NPI Number | 1255061354 |
|---|---|
| Provider Enumeration Date | 06/13/2022 |
| Last Update Date | 06/13/2022 |
| Certification Date | 06/13/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255061354 | NPI | - | NPPES |
| D5352890 | Other | CA | DL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223D0001X | Dentist - Dental Public Health | () | Primary |
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