| United States Air Force | |
|
101 Bodin Cir Travis Afb CA 94535-1809 | |
| (707) 423-7008 | |
| Not Available |
| Full Name | United States Air Force |
|---|---|
| Speciality | Dentist |
| Location | 101 Bodin Cir, Travis Afb, California |
| Authorized Official Name and Position | Martin Hamilton (AEGD PROGRAM DIRECTOR) |
| Authorized Official Contact | 7074237008 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| United States Air Force 101 Bodin Cir Travis Afb CA 94535-1809 Ph: () - | United States Air Force 101 Bodin Cir Travis Afb CA 94535-1809 Ph: (707) 423-7008 |
| NPI Number | 1548713084 |
|---|---|
| Provider Enumeration Date | 08/02/2016 |
| Last Update Date | 08/02/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1548713084 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 019030225 (Illinois) | Primary |
Dentrust, P.c. Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 461 Skymaster Cir Bldg 648, Travis Afb, CA 94535 Phone: 707-474-4599 Fax: 707-402-6535 |