| Diamond Springs Dental | |
|
540 Main Street Ste. 102 Post Office Box 500 Diamond Springs CA 95619-0500 | |
| (530) 344-0290 | |
| (530) 344-0291 |
| Full Name | Diamond Springs Dental |
|---|---|
| Speciality | Dentist |
| Location | 540 Main Street, Diamond Springs, California |
| Authorized Official Name and Position | Mitchell A Goodis (DENTIST) |
| Authorized Official Contact | 5303440290 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Diamond Springs Dental Po Box 500 Ste. 102 Diamond Springs CA 95619-0500 Ph: (530) 344-0290 | Diamond Springs Dental 540 Main Street Ste. 102 Post Office Box 500 Diamond Springs CA 95619-0500 Ph: (530) 344-0290 |
| NPI Number | 1235377623 |
|---|---|
| Provider Enumeration Date | 01/23/2009 |
| Last Update Date | 10/04/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235377623 | NPI | - | NPPES |
| 130082 | Other | CA | UMITED CONCORDIA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | D43010 (California) | Primary |
Diamond Springs Dental Center Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 540 Main St, Diamond Springs, CA 95619 Phone: 530-600-2835 |