| Hacienda Dental, Inc | |
|
5674 Stoneridge Dr Suite 111 Pleasanton CA 94588-8500 | |
| (925) 734-0104 | |
| (924) 734-0489 |
| Full Name | Hacienda Dental, Inc |
|---|---|
| Speciality | Dentist |
| Location | 5674 Stoneridge Dr, Pleasanton, California |
| Authorized Official Name and Position | Wilson Myers (OWNER/DOCTOR) |
| Authorized Official Contact | 9257340104 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Hacienda Dental, Inc 5674 Stoneridge Dr Suite 111 Pleasanton CA 94588-8500 Ph: (925) 734-0104 | Hacienda Dental, Inc 5674 Stoneridge Dr Suite 111 Pleasanton CA 94588-8500 Ph: (925) 734-0104 |
| NPI Number | 1619126398 |
|---|---|
| Provider Enumeration Date | 09/17/2008 |
| Last Update Date | 09/17/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619126398 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 24840 (California) | Primary |
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