| Tahoe City Dental Group | |
|
140 Mackinaw St Tahoe City CA 96145 | |
| (530) 583-0278 | |
| (530) 583-8660 |
| Full Name | Tahoe City Dental Group |
|---|---|
| Speciality | Dentist |
| Location | 140 Mackinaw St, Tahoe City, California |
| Authorized Official Name and Position | Richard Raymond Tomlinson (OWNER PARTNER DDS) |
| Authorized Official Contact | 5305830278 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Tahoe City Dental Group Po Box 5129 140 Mackinaw St Tahoe City CA 96145 Ph: (530) 583-0278 | Tahoe City Dental Group 140 Mackinaw St Tahoe City CA 96145 Ph: (530) 583-0278 |
| NPI Number | 1043393739 |
|---|---|
| Provider Enumeration Date | 10/24/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043393739 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 25458 (California) | Secondary |
| 122300000X | Dentist | 41219 (California) | Primary |
Jack L. Semmens Dds Dental Corporation Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 495 No Lake Blvd, Suite 270, Tahoe City, CA 96145 Phone: 530-583-5546 | |
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 |