| Children's Dental Group | |
|
911 W. Perdew Ave. Ridgecrest CA 93555-3105 | |
| (760) 446-8688 | |
| (760) 446-8691 |
| Full Name | Children's Dental Group |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 911 W. Perdew Ave., Ridgecrest, California |
| Authorized Official Name and Position | Robert Bang (OWNER) |
| Authorized Official Contact | 7604468688 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Children's Dental Group 911 W. Perdew Ave. Ridgecrest CA 93555-3105 Ph: (760) 446-8688 | Children's Dental Group 911 W. Perdew Ave. Ridgecrest CA 93555-3105 Ph: (760) 446-8688 |
| NPI Number | 1538228341 |
|---|---|
| Provider Enumeration Date | 12/07/2006 |
| Last Update Date | 01/06/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538228341 | NPI | - | NPPES |
| B43114 | Other | CA | HEALTHY FAMILIES |
| G92759 | Other | CA | MEDI-CAL PROVIDER # |
| 1524471 | Other | CA | UNITED CONCORDIA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 43114 (California) | Primary |
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