| Capital Periodontal Group | |
|
1810 Professional Drive Sacramento CA 95825 | |
| (916) 971-3461 | |
| (916) 973-9830 |
| Full Name | Capital Periodontal Group |
|---|---|
| Speciality | Dentist - Periodontics |
| Location | 1810 Professional Drive, Sacramento, California |
| Authorized Official Name and Position | Aristidis Pontikas (PERIODONTIST) |
| Authorized Official Contact | 9169713461 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Capital Periodontal Group Po Box 255747 Sacramento CA 95865 Ph: (916) 394-6555 | Capital Periodontal Group 1810 Professional Drive Sacramento CA 95825 Ph: (916) 971-3461 |
| NPI Number | 1568597516 |
|---|---|
| Provider Enumeration Date | 02/22/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568597516 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0300X | Dentist - Periodontics | (* (Not Available)) | Primary |
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