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4744 Telephone Rd Ste 4 Ventura CA 93003-5258 | |
| (805) 653-0620 | |
| (805) 658-6459 |
| Full Name | |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 4744 Telephone Rd Ste 4, Ventura, California |
| Authorized Official Name and Position | Dale Russell Parry (PRESIDENT) |
| Authorized Official Contact | 8056530620 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
4744 Telephone Rd Ste 4 Ventura CA 93003-5258 Ph: (805) 653-0620 | 4744 Telephone Rd Ste 4 Ventura CA 93003-5258 Ph: (805) 653-0620 |
| NPI Number | 1275673410 |
|---|---|
| Provider Enumeration Date | 02/07/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275673410 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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