Fore Dental A Professional Corporation | |
463 Sutton Way Grass Valley CA 95945-4102 | |
(530) 273-1470 | |
(530) 272-5409 |
Full Name | Fore Dental A Professional Corporation |
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Speciality | Dentist |
Location | 463 Sutton Way, Grass Valley, California |
Authorized Official Name and Position | Stacy Fore (OWNER) |
Authorized Official Contact | 5302731470 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Fore Dental A Professional Corporation 463 Sutton Way Grass Valley CA 95945-4102 Ph: (530) 273-1470 | Fore Dental A Professional Corporation 463 Sutton Way Grass Valley CA 95945-4102 Ph: (530) 273-1470 |
NPI Number | 1427485259 |
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Provider Enumeration Date | 10/11/2013 |
Last Update Date | 02/03/2015 |
Identifier | Type | State | Issuer |
---|---|---|---|
1427485259 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
122300000X | Dentist | 40589 (California) | Primary |
332BC3200X | Durable Medical Equipment & Medical Supplies - Customized Equipment | (* (Not Available)) | Secondary |
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