| A Professional Dental Corp. | |
|
3505 Lone Tree Way Ste 7 Antioch CA 94509-6067 | |
| (925) 756-7884 | |
| (925) 756-7894 |
| Full Name | A Professional Dental Corp. |
|---|---|
| Speciality | Dentist - Periodontics |
| Location | 3505 Lone Tree Way, Antioch, California |
| Authorized Official Name and Position | Kelly Ann Butti (OFFICE MANAGER) |
| Authorized Official Contact | 9257567884 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| A Professional Dental Corp. 3505 Lone Tree Way Ste 7 Antioch CA 94509-6067 Ph: (925) 756-7884 | A Professional Dental Corp. 3505 Lone Tree Way Ste 7 Antioch CA 94509-6067 Ph: (925) 756-7884 |
| NPI Number | 1639174279 |
|---|---|
| Provider Enumeration Date | 06/20/2005 |
| Last Update Date | 06/13/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639174279 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0300X | Dentist - Periodontics | 40072 (California) | Primary |
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