Valley Smiles | |
21890 Colorado Ave San Joaquin CA 93660-0737 | |
(559) 693-2462 | |
(559) 693-4382 |
Full Name | Valley Smiles |
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Speciality | Dentist |
Location | 21890 Colorado Ave, San Joaquin, California |
Authorized Official Name and Position | Soyla R. Griffin (CHIEF EXECUTIVE OFFICER) |
Authorized Official Contact | 5596932462 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Valley Smiles Po Box 737 San Joaquin CA 93660-0737 Ph: (559) 693-2462 | Valley Smiles 21890 Colorado Ave San Joaquin CA 93660-0737 Ph: (559) 693-2462 |
NPI Number | 1043376577 |
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Provider Enumeration Date | 12/29/2006 |
Last Update Date | 10/31/2008 |
Identifier | Type | State | Issuer |
---|---|---|---|
1043376577 | NPI | - | NPPES |
FHC03875F | Medicaid | CA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
122300000X | Dentist | 040000522 (California) | Primary |