| Pier 210 Dental Group | |
|
635 Mikkelsen Dr. Auburn CA 95603 | |
| (530) 885-5696 | |
| (530) 885-5698 |
| Full Name | Pier 210 Dental Group |
|---|---|
| Speciality | Dentist |
| Location | 635 Mikkelsen Dr., Auburn, California |
| Authorized Official Name and Position | David H Roholt (PRESIDENT) |
| Authorized Official Contact | 5308855696 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Pier 210 Dental Group 635 Mikkelsen Dr. Auburn CA 95603 Ph: (530) 885-5696 | Pier 210 Dental Group 635 Mikkelsen Dr. Auburn CA 95603 Ph: (530) 885-5696 |
| NPI Number | 1023197019 |
|---|---|
| Provider Enumeration Date | 11/02/2006 |
| Last Update Date | 02/10/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023197019 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 37600 (California) | Primary |
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