| Mantena Dental Corportation | |
|
25005 Blue Ravine Rd Ste 100 Folsom CA 95630-5706 | |
| (916) 984-8050 | |
| Not Available |
| Full Name | Mantena Dental Corportation |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 25005 Blue Ravine Rd Ste 100, Folsom, California |
| Authorized Official Name and Position | Morgan Macdougall (OFFICE MANAGER) |
| Authorized Official Contact | 9165996767 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mantena Dental Corportation 25005 Blue Ravine Rd Ste 100 Folsom CA 95630-5706 Ph: (916) 984-8050 | Mantena Dental Corportation 25005 Blue Ravine Rd Ste 100 Folsom CA 95630-5706 Ph: (916) 984-8050 |
| NPI Number | 1316555253 |
|---|---|
| Provider Enumeration Date | 07/16/2020 |
| Last Update Date | 07/16/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316555253 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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