| Fremont Health Center Dental Group | |
|
2043 E Fremont St Ste 1 Stockton CA 95205-5000 | |
| (209) 463-2345 | |
| (209) 463-1432 |
| Full Name | Fremont Health Center Dental Group |
|---|---|
| Speciality | Dentist |
| Location | 2043 E Fremont St Ste 1, Stockton, California |
| Authorized Official Name and Position | Kelly Pippenger (O.M) |
| Authorized Official Contact | 2094632345 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Fremont Health Center Dental Group 2043 E Fremont St Ste 1 Stockton CA 95205-5000 Ph: (209) 463-2345 | Fremont Health Center Dental Group 2043 E Fremont St Ste 1 Stockton CA 95205-5000 Ph: (209) 463-2345 |
| NPI Number | 1164622882 |
|---|---|
| Provider Enumeration Date | 07/20/2007 |
| Last Update Date | 07/16/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164622882 | NPI | - | NPPES |
| G89962-01 | Other | DENTICAL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | D37743 (California) | Primary |
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