| Mission Ridge Family Dentistry | |
|
43693 Mission Blvd Fremont CA 94539-5832 | |
| (408) 332-4273 | |
| Not Available |
| Full Name | Mission Ridge Family Dentistry |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 43693 Mission Blvd, Fremont, California |
| Authorized Official Name and Position | Chaitanya Bandarupalli (CEO) |
| Authorized Official Contact | 4083324273 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mission Ridge Family Dentistry 40745 Chiltern Dr Fremont CA 94539-3703 Ph: (408) 332-4273 | Mission Ridge Family Dentistry 43693 Mission Blvd Fremont CA 94539-5832 Ph: (408) 332-4273 |
| NPI Number | 1790283935 |
|---|---|
| Provider Enumeration Date | 01/23/2018 |
| Last Update Date | 06/16/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790283935 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | DDS61623 (California) | Primary |
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