|
| |
|
3967 Missouri Flat Road Suite 120 Placerville CA 95667 | |
| (530) 642-2876 | |
| (530) 295-8168 |
| Full Name | |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 3967 Missouri Flat Road, Placerville, California |
| Authorized Official Name and Position | Michael Stout (OWNER) |
| Authorized Official Contact | 5306422876 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
Po Box 920050 Dallas TX 75392-0050 Ph: (714) 845-8890 | 3967 Missouri Flat Road Suite 120 Placerville CA 95667 Ph: (530) 642-2876 |
| NPI Number | 1396141750 |
|---|---|
| Provider Enumeration Date | 11/13/2014 |
| Last Update Date | 02/04/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396141750 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
Tavallaei Dmd Corp Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 4363 Golden Center Dr # A, Placerville, CA 95667 Phone: 916-984-0304 | |
Carl M Hillendahl, D.d.s., Inc. Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 4369 Golden Center Dr, Suite B, Placerville, CA 95667 Phone: 530-626-1700 Fax: 530-626-4879 | |
In Hee Song Dmd, Md, Inc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1004 Fowler Way Ste 9, Placerville, CA 95667 Phone: 530-328-0360 Fax: 530-328-0365 | |
Delgadillo Dds Chun Dds Corp Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 3168 Turner St Ste 300, Placerville, CA 95667 Phone: 530-622-5640 | |
S Jang Dds Incorporated Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 4363 Golden Center Dr # B, Placerville, CA 95667 Phone: 916-984-4224 |