| Autumn Lake Dental | |
|
2199 Main St Oakley CA 94561-3303 | |
| (925) 600-8020 | |
| (925) 452-6323 |
| Full Name | Autumn Lake Dental |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 2199 Main St, Oakley, California |
| Authorized Official Name and Position | Trieu P Ton (DENTIST/PRESIDENT) |
| Authorized Official Contact | 5305743396 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Autumn Lake Dental 400 Del Antico Ave Unit 699 Oakley CA 94561-5632 Ph: (925) 600-8020 | Autumn Lake Dental 2199 Main St Oakley CA 94561-3303 Ph: (925) 600-8020 |
| NPI Number | 1528482999 |
|---|---|
| Provider Enumeration Date | 02/05/2014 |
| Last Update Date | 02/05/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528482999 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 59481 (California) | Primary |
Oakley Orthodontics Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 2170 Main St Ste E, Oakley, CA 94561 Phone: 323-401-6663 | |
Ansony Kim, Dds Inc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 2591 Main St, Oakley, CA 94561 Phone: 925-690-5437 Fax: 925-690-5438 |