| Placerville Dentistry Group | |
|
699 Main St Suit B Placerville CA 95667-5760 | |
| (530) 295-8000 | |
| (530) 295-9072 |
| Full Name | Placerville Dentistry Group |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 699 Main St, Placerville, California |
| Authorized Official Name and Position | Debra Kidder (MANAGER) |
| Authorized Official Contact | 5302958000 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Placerville Dentistry Group 699 Main St Suit B Placerville CA 95667-5760 Ph: (530) 295-8000 | Placerville Dentistry Group 699 Main St Suit B Placerville CA 95667-5760 Ph: (530) 295-8000 |
| NPI Number | 1366862302 |
|---|---|
| Provider Enumeration Date | 04/17/2014 |
| Last Update Date | 04/17/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366862302 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 54818 (California) | Primary |
| 1223G0001X | Dentist - General Practice | 62434 (California) | Secondary |
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