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8940 Vintage Park Dr # 100 Sacramento CA 95829-1627 | |
| (916) 525-3200 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 8940 Vintage Park Dr # 100, Sacramento, California |
| Authorized Official Name and Position | Chang Vong (PRESIDENT) |
| Authorized Official Contact | 9165253200 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
8940 Vintage Park Dr # 100 Sacramento CA 95829-1627 Ph: (916) 525-3200 | 8940 Vintage Park Dr # 100 Sacramento CA 95829-1627 Ph: (916) 525-3200 |
| NPI Number | 1134428816 |
|---|---|
| Provider Enumeration Date | 03/21/2011 |
| Last Update Date | 03/21/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134428816 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 58416 (California) | Primary |
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