| Galt Dental Group | |
|
1067 C St 125 Galt CA 95632-1757 | |
| (209) 744-0463 | |
| (209) 744-8845 |
| Full Name | Galt Dental Group |
|---|---|
| Speciality | Dentist |
| Location | 1067 C St, Galt, California |
| Authorized Official Name and Position | David S Park (OWNER) |
| Authorized Official Contact | 2097440463 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Galt Dental Group 1067 C St 125 Galt CA 95632-1757 Ph: (209) 744-0463 | Galt Dental Group 1067 C St 125 Galt CA 95632-1757 Ph: (209) 744-0463 |
| NPI Number | 1801213442 |
|---|---|
| Provider Enumeration Date | 03/20/2014 |
| Last Update Date | 03/20/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801213442 | NPI | - | NPPES |
| 53274 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 53724 (California) | Primary |
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