| Shasta Community Dental Clinic | |
|
1201 Industrial St Redding CA 96002-0757 | |
| (530) 246-5894 | |
| (530) 241-7838 |
| Full Name | Shasta Community Dental Clinic |
|---|---|
| Speciality | Dentist |
| Location | 1201 Industrial St, Redding, California |
| Authorized Official Name and Position | Jeffery Brandon Thornock (CEO) |
| Authorized Official Contact | 5302465710 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Shasta Community Dental Clinic Po Box 992790 Redding CA 96099-2790 Ph: (530) 246-5894 | Shasta Community Dental Clinic 1201 Industrial St Redding CA 96002-0757 Ph: (530) 246-5894 |
| NPI Number | 1538181557 |
|---|---|
| Provider Enumeration Date | 07/25/2006 |
| Last Update Date | 10/14/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538181557 | NPI | - | NPPES |
| FHC70840F | Other | CA | SCHCDENTAL MEDI-CAL NO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 230000297 (California) | Primary |
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