| Hazel Family Dental Care | |
|
4363 Hazel Ave #6 Fair Oaks CA 95628 | |
| (916) 962-3500 | |
| (916) 962-3592 |
| Full Name | Hazel Family Dental Care |
|---|---|
| Speciality | Dentist |
| Location | 4363 Hazel Ave #6, Fair Oaks, California |
| Authorized Official Name and Position | Frank Gontarski (OWNER SOLE PROPRIETOR) |
| Authorized Official Contact | 9169623500 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Hazel Family Dental Care 4363 Hazel Ave #6 Fair Oaks CA 95628 Ph: (916) 962-3500 | Hazel Family Dental Care 4363 Hazel Ave #6 Fair Oaks CA 95628 Ph: (916) 962-3500 |
| NPI Number | 1114147576 |
|---|---|
| Provider Enumeration Date | 04/26/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114147576 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 30217 (California) | Primary |
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Charles Dental Group Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 12344 Fair Oaks Blvd Ste A, Fair Oaks, CA 95628 Phone: 916-721-3367 Fax: 916-583-7445 | |
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