| Community Medical Centers, Tracy Dental | |
|
2135 N Tracy Blvd Tracy CA 95376-2424 | |
| (209) 373-2800 | |
| Not Available |
| Full Name | Community Medical Centers, Tracy Dental |
|---|---|
| Speciality | Clinic/Center |
| Location | 2135 N Tracy Blvd, Tracy, California |
| Authorized Official Name and Position | Christine Noguera (CEO) |
| Authorized Official Contact | 2093732831 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Community Medical Centers, Tracy Dental 7210 Murray Dr Stockton CA 95210-3339 Ph: (209) 373-2800 | Community Medical Centers, Tracy Dental 2135 N Tracy Blvd Tracy CA 95376-2424 Ph: (209) 373-2800 |
| NPI Number | 1497261606 |
|---|---|
| Provider Enumeration Date | 12/26/2017 |
| Last Update Date | 12/26/2017 |
| Medicare PECOS PAC ID | 8426968520 |
|---|---|
| Medicare Enrollment ID | O20180403002209 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497261606 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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