| Tahoe Oral Surgery | |
|
40165 Truckee Airport Rd Ste 303 Truckee CA 96161-4108 | |
| (530) 541-4042 | |
| Not Available |
| Full Name | Tahoe Oral Surgery |
|---|---|
| Speciality | Dentist - Oral And Maxillofacial Surgery |
| Location | 40165 Truckee Airport Rd Ste 303, Truckee, California |
| Authorized Official Name and Position | Rachel Lynne Appelblatt (GENERAL PARTNER) |
| Authorized Official Contact | 9162969006 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Tahoe Oral Surgery 40165 Truckee Airport Rd Ste 303 Truckee CA 96161-4108 Ph: (530) 541-4042 | Tahoe Oral Surgery 40165 Truckee Airport Rd Ste 303 Truckee CA 96161-4108 Ph: (530) 541-4042 |
| NPI Number | 1053870287 |
|---|---|
| Provider Enumeration Date | 03/18/2019 |
| Last Update Date | 03/18/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053870287 | NPI | - | NPPES |
| 1033353511 | Medicaid | NY | |
| 1215073804 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | (* (Not Available)) | Primary |
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