| Bella Terra Dental | |
|
1110 W Kettleman Ln Suite 47 Lodi CA 95240-6031 | |
| (209) 224-8104 | |
| (209) 224-8491 |
| Full Name | Bella Terra Dental |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 1110 W Kettleman Ln, Lodi, California |
| Authorized Official Name and Position | Quyen B Nguyen (DENTIST/ CEO) |
| Authorized Official Contact | 2092248104 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Bella Terra Dental 1110 W Kettleman Ln Suite 47 Lodi CA 95240-6031 Ph: (209) 224-8104 | Bella Terra Dental 1110 W Kettleman Ln Suite 47 Lodi CA 95240-6031 Ph: (209) 224-8104 |
| NPI Number | 1235423575 |
|---|---|
| Provider Enumeration Date | 06/03/2011 |
| Last Update Date | 10/30/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235423575 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 54291 (California) | Primary |
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Bella Terra Dental Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1110 W Kettleman Ln, Ste 47, Lodi, CA 95240 Phone: 209-224-8104 |