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591 Watt Ave Ste 100 Sacramento CA 95864-5027 | |
| (916) 481-5057 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 591 Watt Ave Ste 100, Sacramento, California |
| Authorized Official Name and Position | Erick N Cuenca (OWNER) |
| Authorized Official Contact | 7144281200 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
591 Watt Ave Ste 100 Sacramento CA 95864-5027 Ph: (916) 481-5057 | 591 Watt Ave Ste 100 Sacramento CA 95864-5027 Ph: (916) 481-5057 |
| NPI Number | 1518177682 |
|---|---|
| Provider Enumeration Date | 05/23/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518177682 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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