| Capitol Periodontal Group | |
|
2428 Professional Dr Ste 100 Roseville CA 95661-7774 | |
| (916) 786-6585 | |
| (916) 786-7542 |
| Full Name | Capitol Periodontal Group |
|---|---|
| Speciality | Dentist - Periodontics |
| Location | 2428 Professional Dr, Roseville, California |
| Authorized Official Name and Position | Susan Dilworth (FINANCIAL ASSISTANT) |
| Authorized Official Contact | 9163946555 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Capitol Periodontal Group Po Box 255727 Sacramento CA 95865-5727 Ph: (916) 394-6555 | Capitol Periodontal Group 2428 Professional Dr Ste 100 Roseville CA 95661-7774 Ph: (916) 786-6585 |
| NPI Number | 1235321852 |
|---|---|
| Provider Enumeration Date | 08/16/2007 |
| Last Update Date | 08/16/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235321852 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0300X | Dentist - Periodontics | (* (Not Available)) | Primary |
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