| Surfside Kids Dental | |
|
6942 Almaden Expy # 11 San Jose CA 95120-3201 | |
| (480) 235-8541 | |
| Not Available |
| Full Name | Surfside Kids Dental |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 6942 Almaden Expy # 11, San Jose, California |
| Authorized Official Name and Position | Joseph Rawlins (PRESIDENT) |
| Authorized Official Contact | 9162299941 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Surfside Kids Dental Po Box 4785 El Dorado Hills CA 95762-0024 Ph: (916) 229-9941 | Surfside Kids Dental 6942 Almaden Expy # 11 San Jose CA 95120-3201 Ph: (480) 235-8541 |
| NPI Number | 1942662457 |
|---|---|
| Provider Enumeration Date | 03/23/2016 |
| Last Update Date | 03/25/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942662457 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | 56958 (California) | Primary |
| 1223X0400X | Dentist - Orthodontics And Dentofacial Orthopedics | 51968 (California) | Secondary |
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