| Walnut Plaza Dental | |
|
903 W Center St Ste 5 Manteca CA 95337-7315 | |
| (209) 824-0214 | |
| (209) 824-0812 |
| Full Name | Walnut Plaza Dental |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 903 W Center St Ste 5, Manteca, California |
| Authorized Official Name and Position | Matthew Kim (CEO) |
| Authorized Official Contact | 2096429340 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Walnut Plaza Dental 903 W Center St Ste 5 Manteca CA 95337-7315 Ph: (209) 824-0214 | Walnut Plaza Dental 903 W Center St Ste 5 Manteca CA 95337-7315 Ph: (209) 824-0214 |
| NPI Number | 1659943280 |
|---|---|
| Provider Enumeration Date | 07/13/2021 |
| Last Update Date | 08/18/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659943280 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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