Volterra Dental | |
3532 Howard Ave Ste 200 Los Alamitos CA 90720-3699 | |
(562) 596-7484 | |
Not Available |
Full Name | Volterra Dental |
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Speciality | Dentist |
Location | 3532 Howard Ave Ste 200, Los Alamitos, California |
Authorized Official Name and Position | Richard Blackburn (OWNER) |
Authorized Official Contact | 5625967484 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Volterra Dental 3532 Howard Ave Ste 200 Los Alamitos CA 90720-3699 Ph: () - | Volterra Dental 3532 Howard Ave Ste 200 Los Alamitos CA 90720-3699 Ph: (562) 596-7484 |
NPI Number | 1457023921 |
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Provider Enumeration Date | 10/01/2021 |
Last Update Date | 12/03/2021 |
Medicare PECOS PAC ID | 1557752508 |
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Medicare Enrollment ID | O20211229001660 |
Identifier | Type | State | Issuer |
---|---|---|---|
1457023921 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
122300000X | Dentist | (* (Not Available)) | Primary |
Provider Name | Richard Blackburn |
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Provider Type | Practitioner - Dentist |
Provider Identifiers | NPI Number: 1891215760 PECOS PAC ID: 2466843412 Enrollment ID: I20211229001706 |
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