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1158 Suncast Ln Ste #1 El Dorado Hills CA 95762-9326 | |
| (916) 941-9888 | |
| (916) 358-5638 |
| Full Name | |
|---|---|
| Speciality | Dentist - Endodontics |
| Location | 1158 Suncast Ln, El Dorado Hills, California |
| Authorized Official Name and Position | David Koehn (OWNER) |
| Authorized Official Contact | 9169419888 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
1158 Suncast Ln Ste #1 El Dorado Hills CA 95762-9326 Ph: (916) 941-9888 | 1158 Suncast Ln Ste #1 El Dorado Hills CA 95762-9326 Ph: (916) 941-9888 |
| NPI Number | 1558548495 |
|---|---|
| Provider Enumeration Date | 01/23/2008 |
| Last Update Date | 01/23/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558548495 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223E0200X | Dentist - Endodontics | 48932 (California) | Primary |
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