| Shine On Dental Group | |
|
1501 Bollinger Canyon Rd Ste F San Ramon CA 94583-1758 | |
| (510) 857-7544 | |
| (925) 208-1852 |
| Full Name | Shine On Dental Group |
|---|---|
| Speciality | Dentist |
| Location | 1501 Bollinger Canyon Rd Ste F, San Ramon, California |
| Authorized Official Name and Position | Shiva Mohtasham (OWNER) |
| Authorized Official Contact | 5108577544 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Shine On Dental Group 2887 Fieldview Ter San Ramon CA 94583-1900 Ph: (510) 857-7544 | Shine On Dental Group 1501 Bollinger Canyon Rd Ste F San Ramon CA 94583-1758 Ph: (510) 857-7544 |
| NPI Number | 1619349511 |
|---|---|
| Provider Enumeration Date | 10/30/2015 |
| Last Update Date | 10/30/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619349511 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 51976 (California) | Primary |
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