| Van Sicklen DDS Inc | |
|
1372 W Robinhood Dr Ste A Stockton CA 95207-5513 | |
| (209) 607-6956 | |
| Not Available |
| Full Name | Van Sicklen DDS Inc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 1372 W Robinhood Dr Ste A, Stockton, California |
| Authorized Official Name and Position | Charles Neal Van Sicklen (CEO) |
| Authorized Official Contact | 2096076956 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Van Sicklen DDS Inc 9591 Ruff Ave Stockton CA 95212-2417 Ph: (209) 607-6956 | Van Sicklen DDS Inc 1372 W Robinhood Dr Ste A Stockton CA 95207-5513 Ph: (209) 607-6956 |
| NPI Number | 1205406915 |
|---|---|
| Provider Enumeration Date | 06/26/2021 |
| Last Update Date | 07/14/2021 |
| Certification Date | 07/14/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205406915 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (NU) | Primary |
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