| Dental Source Of California | |
|
7616 Pacific Ave Stockton CA 95207-1952 | |
| (209) 952-1641 | |
| (209) 952-2856 |
| Full Name | Dental Source Of California |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 7616 Pacific Ave, Stockton, California |
| Authorized Official Name and Position | Donald Clarke (PRESIDENT, DONALD E. CLARKE, D.D.S.) |
| Authorized Official Contact | 9164870117 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dental Source Of California 7616 Pacific Ave Stockton CA 95207-1952 Ph: (209) 952-1641 | Dental Source Of California 7616 Pacific Ave Stockton CA 95207-1952 Ph: (209) 952-1641 |
| NPI Number | 1073939617 |
|---|---|
| Provider Enumeration Date | 03/06/2014 |
| Last Update Date | 03/06/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073939617 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 33738 (California) | Primary |
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