| A Professional Dental Corporation | |
|
1204 Cottonwood St Suite 1 Woodland CA 95695-4362 | |
| (530) 662-9191 | |
| (530) 662-3568 |
| Full Name | A Professional Dental Corporation |
|---|---|
| Speciality | Dentist - Orthodontics And Dentofacial Orthopedics |
| Location | 1204 Cottonwood St, Woodland, California |
| Authorized Official Name and Position | Richard Henry Portalupi (OWNER) |
| Authorized Official Contact | 5306629191 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| A Professional Dental Corporation 1204 Cottonwood St Suite 1 Woodland CA 95695-4362 Ph: (530) 662-9191 | A Professional Dental Corporation 1204 Cottonwood St Suite 1 Woodland CA 95695-4362 Ph: (530) 662-9191 |
| NPI Number | 1003020280 |
|---|---|
| Provider Enumeration Date | 05/09/2007 |
| Last Update Date | 02/15/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003020280 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223X0400X | Dentist - Orthodontics And Dentofacial Orthopedics | DDS25066 (California) | Primary |
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