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1620 W El Camino Ave Suite 115 Sacramento CA 95833-3617 | |
| (916) 924-8391 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Dentist |
| Location | 1620 W El Camino Ave, Sacramento, California |
| Authorized Official Name and Position | Dennis Lai (PARTNER) |
| Authorized Official Contact | 9169248391 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
1620 W El Camino Ave Suite 115 Sacramento CA 95833-3617 Ph: () - | 1620 W El Camino Ave Suite 115 Sacramento CA 95833-3617 Ph: (916) 924-8391 |
| NPI Number | 1558554964 |
|---|---|
| Provider Enumeration Date | 08/20/2007 |
| Last Update Date | 08/20/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558554964 | NPI | - | NPPES |
| 25815 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 25815 (California) | Primary |
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