| 17th Street Dental Care | |
|
1621 17th St Bakersfield CA 93301-4300 | |
| (661) 631-0529 | |
| Not Available |
| Full Name | 17th Street Dental Care |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 1621 17th St, Bakersfield, California |
| Authorized Official Name and Position | Karen J Camp (MANAGER) |
| Authorized Official Contact | 6616310529 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| 17th Street Dental Care 1621 17th St Bakersfield CA 93301-4300 Ph: (661) 631-0529 | 17th Street Dental Care 1621 17th St Bakersfield CA 93301-4300 Ph: (661) 631-0529 |
| NPI Number | 1952770455 |
|---|---|
| Provider Enumeration Date | 09/15/2015 |
| Last Update Date | 09/15/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1952770455 | NPI | - | NPPES |
| 43593 | Other | CA | DENTAL LISC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 43593 (California) | Primary |
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