| Central Coast Pediatric Dental Group | |
|
945 Blanco Circle Suite D Salinas CA 93901 | |
| (831) 424-0641 | |
| (831) 424-0888 |
| Full Name | Central Coast Pediatric Dental Group |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 945 Blanco Circle Suite D, Salinas, California |
| Authorized Official Name and Position | Anna M Lizaola (ADMINISTRATIVE ASSISTANT) |
| Authorized Official Contact | 8314428878 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Central Coast Pediatric Dental Group 631 E Alvin Drive Suite C Salinas CA 93906 Ph: (831) 442-8878 | Central Coast Pediatric Dental Group 945 Blanco Circle Suite D Salinas CA 93901 Ph: (831) 424-0641 |
| NPI Number | 1033242144 |
|---|---|
| Provider Enumeration Date | 03/14/2007 |
| Last Update Date | 03/25/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033242144 | NPI | - | NPPES |
| G9087501 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | 37400 (California) | Primary |
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