| Harbor Dental Group | |
|
825 Harbor Blvd West Sacramento CA 95691 | |
| (916) 372-8525 | |
| (916) 372-5971 |
| Full Name | Harbor Dental Group |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 825 Harbor Blvd, West Sacramento, California |
| Authorized Official Name and Position | Yuly Vilderman (CEO) |
| Authorized Official Contact | 9163728525 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Harbor Dental Group 825 Harbor Blvd West Sacramento CA 95691 Ph: (916) 372-8525 | Harbor Dental Group 825 Harbor Blvd West Sacramento CA 95691 Ph: (916) 372-8525 |
| NPI Number | 1942375068 |
|---|---|
| Provider Enumeration Date | 11/22/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942375068 | NPI | - | NPPES |
| G91180-01 | Other | CA | MEDICAL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | B41689 (California) | Primary |
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