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8851 Greenback Ln Orangevale CA 95662-4058 | |
(916) 988-5559 | |
(916) 988-5936 |
Full Name | |
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Speciality | Dentist - General Practice |
Location | 8851 Greenback Ln, Orangevale, California |
Authorized Official Name and Position | Omar Sattout (PRESIDENT) |
Authorized Official Contact | 9092488417 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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740 W Kettleman Ln Lodi CA 95240-6051 Ph: () - | 8851 Greenback Ln Orangevale CA 95662-4058 Ph: (916) 988-5559 |
NPI Number | 1932561453 |
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Provider Enumeration Date | 03/23/2016 |
Last Update Date | 03/23/2016 |
Identifier | Type | State | Issuer |
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1932561453 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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1223G0001X | Dentist - General Practice | 63154 (California) | Primary |