| Peach Tree Dental | |
|
862 Meinecke Avenue Suite 200 San Luis Obispo CA 93405 | |
| (805) 544-7804 | |
| (805) 544-6020 |
| Full Name | Peach Tree Dental |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 862 Meinecke Avenue, San Luis Obispo, California |
| Authorized Official Name and Position | Troy Kendall Slade (DENTIST/OWNER) |
| Authorized Official Contact | 8055447804 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Peach Tree Dental 862 Meinecke Avenue Suite 200 San Luis Obispo CA 93405 Ph: (805) 544-7804 | Peach Tree Dental 862 Meinecke Avenue Suite 200 San Luis Obispo CA 93405 Ph: (805) 544-7804 |
| NPI Number | 1750506036 |
|---|---|
| Provider Enumeration Date | 04/13/2007 |
| Last Update Date | 08/04/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750506036 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 58800 (California) | Primary |
| 1223G0001X | Dentist - General Practice | 62898 (California) | Secondary |
Pacific Pediatric Dentistry Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1231 Osos St, San Luis Obispo, CA 93401 Phone: 805-544-3434 Fax: 805-544-3443 | |
Ricuccio A. Negom Dds, A Professioal Dental Corporation Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 735 Tank Farm Rd Ste 170, San Luis Obispo, CA 93401 Phone: 805-549-9000 Fax: 805-549-9004 | |
San Luis Oral And Maxillofacial Surgery And Dental Implant Center Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 77 Casa St, Suite 101, San Luis Obispo, CA 93405 Phone: 805-541-5611 Fax: 805-541-2328 | |
Pacific Pediatric Dentistry Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1231 Osos St, San Luis Obispo, CA 93401 Phone: 805-544-3434 Fax: 805-544-3443 | |
Doan Dds Inc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 4251 S Higuera St Ste 101, San Luis Obispo, CA 93401 Phone: 805-538-1888 | |
Ron Barbieri Dds, Inc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1131 Pacific St, San Luis Obispo, CA 93401 Phone: 805-543-0753 | |
Jac W. Pedersen Ii, D.d.s., Inc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 620 California Blvd Ste H, San Luis Obispo, CA 93401 Phone: 805-544-8111 Fax: 805-544-6309 |