| Prestige Dental Care | |
|
38750 Trade Center Dr Ste J Palmdale CA 93551-3787 | |
| (661) 267-6400 | |
| Not Available |
| Full Name | Prestige Dental Care |
|---|---|
| Speciality | Dentist |
| Location | 38750 Trade Center Dr Ste J, Palmdale, California |
| Authorized Official Name and Position | Randall Sagisi (PRESIDENT) |
| Authorized Official Contact | 6612676400 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Prestige Dental Care 38750 Trade Center Dr Ste J Palmdale CA 93551-3787 Ph: (661) 267-6400 | Prestige Dental Care 38750 Trade Center Dr Ste J Palmdale CA 93551-3787 Ph: (661) 267-6400 |
| NPI Number | 1013396423 |
|---|---|
| Provider Enumeration Date | 05/19/2015 |
| Last Update Date | 05/19/2015 |
| Medicare PECOS PAC ID | 5597095570 |
|---|---|
| Medicare Enrollment ID | O20190918002544 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013396423 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 63715 (California) | Primary |
| Provider Name | Randall A Sagisi |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1285976795 PECOS PAC ID: 6406186485 Enrollment ID: I20190918002685 |
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