| The Health Trust | |
|
645 Wool Creek Dr San Jose CA 95112-2617 | |
| (408) 961-9869 | |
| Not Available |
| Full Name | The Health Trust |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 645 Wool Creek Dr, San Jose, California |
| Authorized Official Name and Position | Ira Holtzman (CHIEF FINANCIAL OFFICER) |
| Authorized Official Contact | 4089619869 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| The Health Trust 2085 Hamilton Ave Ste. 150 San Jose CA 95125-6117 Ph: (408) 961-9869 | The Health Trust 645 Wool Creek Dr San Jose CA 95112-2617 Ph: (408) 961-9869 |
| NPI Number | 1790900215 |
|---|---|
| Provider Enumeration Date | 04/17/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790900215 | NPI | - | NPPES |
| G91493-01 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | G91493-01 (California) | Primary |
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