| Roseville Kids Dentist | |
|
1253 Pleasant Grove Blvd Ste 190 Roseville CA 95678-6983 | |
| (916) 773-5230 | |
| (916) 474-5249 |
| Full Name | Roseville Kids Dentist |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 1253 Pleasant Grove Blvd Ste 190, Roseville, California |
| Authorized Official Name and Position | Jude Crutchfield (OWNER) |
| Authorized Official Contact | 9167735230 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Roseville Kids Dentist 5420 Park Dr Rocklin CA 95765-5562 Ph: (916) 435-5230 | Roseville Kids Dentist 1253 Pleasant Grove Blvd Ste 190 Roseville CA 95678-6983 Ph: (916) 773-5230 |
| NPI Number | 1033639463 |
|---|---|
| Provider Enumeration Date | 06/27/2017 |
| Last Update Date | 08/02/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033639463 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | 58211 (California) | Primary |
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