| Feldkamp Cal Select Dental Group, Inc. | |
|
15743 Main St Hesperia CA 92345-3410 | |
| (760) 981-1045 | |
| Not Available |
| Full Name | Feldkamp Cal Select Dental Group, Inc. |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 15743 Main St, Hesperia, California |
| Authorized Official Name and Position | Irving Moore Feldkamp Iii (OWNER) |
| Authorized Official Contact | 9094536600 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Feldkamp Cal Select Dental Group, Inc. Po Box 10669 San Bernardino CA 92423-0669 Ph: () - | Feldkamp Cal Select Dental Group, Inc. 15743 Main St Hesperia CA 92345-3410 Ph: (760) 981-1045 |
| NPI Number | 1790302784 |
|---|---|
| Provider Enumeration Date | 06/25/2020 |
| Last Update Date | 08/18/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790302784 | NPI | - | NPPES |
| 19806838 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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