| Duane Nowack A Professional Dental Corporation | |
|
1721 Main St Ste 108 Ramona CA 92065-2240 | |
| (760) 789-7002 | |
| Not Available |
| Full Name | Duane Nowack A Professional Dental Corporation |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 1721 Main St Ste 108, Ramona, California |
| Authorized Official Name and Position | Duane C Nowack (OWNER) |
| Authorized Official Contact | 7607897002 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Duane Nowack A Professional Dental Corporation 1721 Main St Ste 108 Ramona CA 92065-2240 Ph: (760) 789-7002 | Duane Nowack A Professional Dental Corporation 1721 Main St Ste 108 Ramona CA 92065-2240 Ph: (760) 789-7002 |
| NPI Number | 1780738203 |
|---|---|
| Provider Enumeration Date | 01/22/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1780738203 | NPI | - | NPPES |
| 541022 | Other | CA | PROV. # UNITED CONCORDIA |
| B-15103-01 | Other | CA | MEDI- CAL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 15103 (California) | Primary |
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