| Capitol Periodontal Group | |
|
2535 E Bidwell St Ste 150 Folsom CA 95630-6458 | |
| (916) 984-1109 | |
| (916) 984-1764 |
| Full Name | Capitol Periodontal Group |
|---|---|
| Speciality | Dentist - Periodontics |
| Location | 2535 E Bidwell St Ste 150, Folsom, California |
| Authorized Official Name and Position | Renee Blake (INSURANCE SPECIALIST) |
| Authorized Official Contact | 9166911050 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Capitol Periodontal Group 9309 Office Park Cir Ste 120 Elk Grove CA 95758-8072 Ph: (916) 691-1050 | Capitol Periodontal Group 2535 E Bidwell St Ste 150 Folsom CA 95630-6458 Ph: (916) 984-1109 |
| NPI Number | 1962735993 |
|---|---|
| Provider Enumeration Date | 09/09/2009 |
| Last Update Date | 09/09/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962735993 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0300X | Dentist - Periodontics | 22639744 (California) | Primary |
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