| Thaddous Archie, Dds | |
|
8013 Laguna Blvd Ste 2 Elk Grove CA 95758-8130 | |
| (916) 691-6020 | |
| (916) 691-6022 |
| Full Name | Thaddous Archie, Dds |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 8013 Laguna Blvd Ste 2, Elk Grove, California |
| Authorized Official Name and Position | Jessica Guerrero (CONTRACT CORDINATOR) |
| Authorized Official Contact | 9166916020 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Thaddous Archie, Dds 8013 Laguna Blvd Ste 2 Elk Grove CA 95758-8130 Ph: (916) 691-6020 | Thaddous Archie, Dds 8013 Laguna Blvd Ste 2 Elk Grove CA 95758-8130 Ph: (916) 691-6020 |
| NPI Number | 1598588451 |
|---|---|
| Provider Enumeration Date | 11/07/2024 |
| Last Update Date | 11/07/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598588451 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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