| New City Dental Practice | |
|
4847 Lone Tree Way Ste B Antioch CA 94531-8612 | |
| (925) 755-4040 | |
| (925) 755-4041 |
| Full Name | New City Dental Practice |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 4847 Lone Tree Way Ste B, Antioch, California |
| Authorized Official Name and Position | Grace Cabildo Rivera (DOCTOR/OWNER) |
| Authorized Official Contact | 9257554040 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| New City Dental Practice 4847 Lone Tree Way Ste B Antioch CA 94531-8612 Ph: (925) 755-4040 | New City Dental Practice 4847 Lone Tree Way Ste B Antioch CA 94531-8612 Ph: (925) 755-4040 |
| NPI Number | 1215953112 |
|---|---|
| Provider Enumeration Date | 07/14/2006 |
| Last Update Date | 10/02/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215953112 | NPI | - | NPPES |
| 341996792 | Other | CA | OLD TAX I.D NUMBER |
| B48364-01 | Other | CA | HEALTHY FAMILIES PROVIDER |
| 1332285 | Other | CA | UNITED CONCORDIA PROVIDER |
| G9337801 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 48364 (California) | Primary |
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