Carlene A Mendieta Dds | |
1420 Tara Hills Dr #c Pinole CA 94564-2530 | |
(510) 724-8441 | |
(510) 724-0120 |
Full Name | Carlene A Mendieta Dds |
---|---|
Speciality | Dentist - Periodontics |
Location | 1420 Tara Hills Dr, Pinole, California |
Authorized Official Name and Position | Carlene A Mendieta (OWNER) |
Authorized Official Contact | 5107248441 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Carlene A Mendieta Dds 1420 Tara Hills Dr #c Pinole CA 94564-2530 Ph: (510) 724-8441 | Carlene A Mendieta Dds 1420 Tara Hills Dr #c Pinole CA 94564-2530 Ph: (510) 724-8441 |
NPI Number | 1780668020 |
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Provider Enumeration Date | 11/30/2005 |
Last Update Date | 07/14/2008 |
Identifier | Type | State | Issuer |
---|---|---|---|
1780668020 | NPI | - | NPPES |
DA34741 | Other | CA | LICENSE NUMBER |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1223P0300X | Dentist - Periodontics | DA34741 (California) | Primary |
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