| Great Smile Dental Group | |
|
311 Oak Ridge Dr Ste 4 Roseville CA 95661-3427 | |
| (916) 784-6510 | |
| (916) 784-9017 |
| Full Name | Great Smile Dental Group |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 311 Oak Ridge Dr Ste 4, Roseville, California |
| Authorized Official Name and Position | Woo Jung Lee (CEO) |
| Authorized Official Contact | 9167846510 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Great Smile Dental Group 311 Oak Ridge Dr Ste 4 Roseville CA 95661-3427 Ph: (916) 784-6510 | Great Smile Dental Group 311 Oak Ridge Dr Ste 4 Roseville CA 95661-3427 Ph: (916) 784-6510 |
| NPI Number | 1255510160 |
|---|---|
| Provider Enumeration Date | 10/26/2007 |
| Last Update Date | 10/26/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255510160 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 50484 (California) | Primary |
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