| Cerulean Dental Spa | |
|
3967 Rivermark Plz Santa Clara CA 95054-4156 | |
| (408) 988-1588 | |
| Not Available |
| Full Name | Cerulean Dental Spa |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 3967 Rivermark Plz, Santa Clara, California |
| Authorized Official Name and Position | Tommy P Lee (PRESIDENT) |
| Authorized Official Contact | 4089881588 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Cerulean Dental Spa 3967 Rivermark Plz Santa Clara CA 95054-4156 Ph: () - | Cerulean Dental Spa 3967 Rivermark Plz Santa Clara CA 95054-4156 Ph: (408) 988-1588 |
| NPI Number | 1144365503 |
|---|---|
| Provider Enumeration Date | 02/21/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144365503 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 48309 (California) | Primary |
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