| Azouz Dental Practice Of Sacramento Inc | |
|
5414 Sunrise Blvd Ste D Citrus Heights CA 95610-7803 | |
| (916) 961-3383 | |
| Not Available |
| Full Name | Azouz Dental Practice Of Sacramento Inc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 5414 Sunrise Blvd Ste D, Citrus Heights, California |
| Authorized Official Name and Position | Darryl Todd Azouz (OWNER AND DENTIST) |
| Authorized Official Contact | 9167082363 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Azouz Dental Practice Of Sacramento Inc 5414 Sunrise Blvd Ste D Citrus Heights CA 95610-7803 Ph: (916) 961-3383 | Azouz Dental Practice Of Sacramento Inc 5414 Sunrise Blvd Ste D Citrus Heights CA 95610-7803 Ph: (916) 961-3383 |
| NPI Number | 1770052631 |
|---|---|
| Provider Enumeration Date | 11/20/2018 |
| Last Update Date | 11/20/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770052631 | NPI | - | NPPES |
| 1093883464 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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