| Esparto Dental Clinic | |
|
16827 Freemont St. Esparto CA 95627 | |
| (530) 787-4972 | |
| Not Available |
| Full Name | Esparto Dental Clinic |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 16827 Freemont St., Esparto, California |
| Authorized Official Name and Position | Kristie Stanley (DIRECTOR OF CLINICAL INFO SYSTEMS) |
| Authorized Official Contact | 5307533498 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Esparto Dental Clinic Po Box 1260 Davis CA 95617-1260 Ph: (530) 753-3498 | Esparto Dental Clinic 16827 Freemont St. Esparto CA 95627 Ph: (530) 787-4972 |
| NPI Number | 1568680940 |
|---|---|
| Provider Enumeration Date | 04/23/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568680940 | NPI | - | NPPES |
| FHC70985F | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (California) | Primary |