| Tenggren Dental Corp | |
|
1105 Red Tail Way Simi Valley CA 93065-7232 | |
| (805) 577-7733 | |
| (805) 577-7753 |
| Full Name | Tenggren Dental Corp |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 1105 Red Tail Way, Simi Valley, California |
| Authorized Official Name and Position | Stuart P Tenggren (PRESIDENT) |
| Authorized Official Contact | 8055777733 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Tenggren Dental Corp 1105 Red Tail Way Simi Valley CA 93065-7232 Ph: (805) 577-7733 | Tenggren Dental Corp 1105 Red Tail Way Simi Valley CA 93065-7232 Ph: (805) 577-7733 |
| NPI Number | 1437231586 |
|---|---|
| Provider Enumeration Date | 10/19/2006 |
| Last Update Date | 04/07/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1437231586 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 45780 (California) | Primary |
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