| M A C T Health Board, Incorporated | |
|
1113a Highway 49 San Andreas CA 95249 | |
| (209) 755-1460 | |
| Not Available |
| Full Name | M A C T Health Board, Incorporated |
|---|---|
| Speciality | Dentist |
| Location | 1113a Highway 49, San Andreas, California |
| Authorized Official Name and Position | John Alexander (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 2097546258 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| M A C T Health Board, Incorporated Po Box 939 Angels Camp CA 95222-0939 Ph: (209) 754-6262 | M A C T Health Board, Incorporated 1113a Highway 49 San Andreas CA 95249 Ph: (209) 755-1460 |
| NPI Number | 1528508488 |
|---|---|
| Provider Enumeration Date | 02/27/2017 |
| Last Update Date | 11/17/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528508488 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | (* (Not Available)) | Primary |
| 152W00000X | Optometrist | (* (Not Available)) | Secondary |
Thanh Pham Dds Dental Corporation Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 40 Saint Charles St E, San Andreas, CA 95249 Phone: 408-702-7632 |