| Enmer I Tadeo Dds Inc | |
|
2873 W Lincoln Ave Anaheim CA 92801-6226 | |
| (714) 761-7000 | |
| (714) 761-3900 |
| Full Name | Enmer I Tadeo Dds Inc |
|---|---|
| Speciality | Dentist |
| Location | 2873 W Lincoln Ave, Anaheim, California |
| Authorized Official Name and Position | Enmer I Tadeo (PRESIDENT) |
| Authorized Official Contact | 7147617000 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Enmer I Tadeo Dds Inc 2873 W Lincoln Ave Anaheim CA 92801-6226 Ph: (714) 761-7000 | Enmer I Tadeo Dds Inc 2873 W Lincoln Ave Anaheim CA 92801-6226 Ph: (714) 761-7000 |
| NPI Number | 1083038533 |
|---|---|
| Provider Enumeration Date | 02/04/2014 |
| Last Update Date | 01/31/2019 |
| Medicare PECOS PAC ID | 7719224153 |
|---|---|
| Medicare Enrollment ID | O20190123003739 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083038533 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 56591 (California) | Primary |
| Provider Name | Enmer I Tadeo |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1700066230 PECOS PAC ID: 3779820121 Enrollment ID: I20190201001323 |
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