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9197 Greenback Ln Ste B Orangevale CA 95662-4792 | |
(916) 259-9255 | |
(916) 384-3844 |
Full Name | |
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Speciality | Dentist - Pediatric Dentistry |
Location | 9197 Greenback Ln Ste B, Orangevale, California |
Authorized Official Name and Position | Brian Crawford (OWNER) |
Authorized Official Contact | 9162599255 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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3075 Beacon Blvd West Sacramento CA 95691-3462 Ph: (916) 259-9255 | 9197 Greenback Ln Ste B Orangevale CA 95662-4792 Ph: (916) 259-9255 |
NPI Number | 1659801470 |
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Provider Enumeration Date | 06/14/2017 |
Last Update Date | 11/13/2024 |
Identifier | Type | State | Issuer |
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1659801470 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1223P0221X | Dentist - Pediatric Dentistry | (* (Not Available)) | Primary |