| Dental Source Of California | |
|
1930 9th St Ste 105 Sacramento CA 95811-7076 | |
| (916) 393-7336 | |
| Not Available |
| Full Name | Dental Source Of California |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 1930 9th St Ste 105, Sacramento, California |
| Authorized Official Name and Position | Donald Clarke (PRESIDENT OF CORPORATION) |
| Authorized Official Contact | 9164860117 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dental Source Of California 1930 9th St Ste 105 Sacramento CA 95811-7076 Ph: (916) 393-7336 | Dental Source Of California 1930 9th St Ste 105 Sacramento CA 95811-7076 Ph: (916) 393-7336 |
| NPI Number | 1992720627 |
|---|---|
| Provider Enumeration Date | 07/13/2006 |
| Last Update Date | 10/14/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992720627 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 33738 (California) | Primary |
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