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12120 Industry Blvd Ste 35 Jackson CA 95642-9374 | |
| (209) 353-3275 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Dentist |
| Location | 12120 Industry Blvd Ste 35, Jackson, California |
| Authorized Official Name and Position | Sukhjeet Kaur (PRESIDENT) |
| Authorized Official Contact | 5166039071 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
12120 Industry Blvd Ste 35 Jackson CA 95642-9374 Ph: () - | 12120 Industry Blvd Ste 35 Jackson CA 95642-9374 Ph: (209) 353-3275 |
| NPI Number | 1598131336 |
|---|---|
| Provider Enumeration Date | 08/17/2015 |
| Last Update Date | 08/17/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598131336 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 60389 (California) | Primary |
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