| Truckee Pediatric Dentistry | |
|
11149 Brockway Rd Ste 100 Truckee CA 96161-2212 | |
| (530) 550-9311 | |
| (530) 550-8655 |
| Full Name | Truckee Pediatric Dentistry |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 11149 Brockway Rd Ste 100, Truckee, California |
| Authorized Official Name and Position | Matthew Gustafsson (OWNER/DENTIST) |
| Authorized Official Contact | 5305509311 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Truckee Pediatric Dentistry 11149 Brockway Rd Ste 100 Truckee CA 96161-2212 Ph: (530) 550-9311 | Truckee Pediatric Dentistry 11149 Brockway Rd Ste 100 Truckee CA 96161-2212 Ph: (530) 550-9311 |
| NPI Number | 1144559162 |
|---|---|
| Provider Enumeration Date | 12/22/2009 |
| Last Update Date | 02/27/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144559162 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | 55527 (California) | Primary |
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