| Greenhaven Family Dental Llc | |
|
925 Secret River Dr Ste A Sacramento CA 95831-3465 | |
| (916) 421-3815 | |
| Not Available |
| Full Name | Greenhaven Family Dental Llc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 925 Secret River Dr Ste A, Sacramento, California |
| Authorized Official Name and Position | Jerome Pielago (MANAGING DENTIST/OWNER) |
| Authorized Official Contact | 9164125034 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Greenhaven Family Dental Llc 925 Secret River Dr Ste A Sacramento CA 95831-3465 Ph: (916) 421-3815 | Greenhaven Family Dental Llc 925 Secret River Dr Ste A Sacramento CA 95831-3465 Ph: (916) 421-3815 |
| NPI Number | 1730771353 |
|---|---|
| Provider Enumeration Date | 02/04/2021 |
| Last Update Date | 02/04/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730771353 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | (* (Not Available)) | Secondary |
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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