A Professional Dental Corp. | |
1341 N El Dorado St Stockton CA 95202-1016 | |
(209) 465-5747 | |
(206) 465-3602 |
Full Name | A Professional Dental Corp. |
---|---|
Speciality | Dentist - General Practice |
Location | 1341 N El Dorado St, Stockton, California |
Authorized Official Name and Position | Everett Leman Low (SECRETARY/TREASURER) |
Authorized Official Contact | 2094655747 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
A Professional Dental Corp. 1341 N El Dorado St Stockton CA 95202-1016 Ph: (209) 465-5747 | A Professional Dental Corp. 1341 N El Dorado St Stockton CA 95202-1016 Ph: (209) 465-5747 |
NPI Number | 1184818569 |
---|---|
Provider Enumeration Date | 08/29/2007 |
Last Update Date | 10/10/2019 |
Identifier | Type | State | Issuer |
---|---|---|---|
1184818569 | NPI | - | NPPES |
26885-01 | Medicaid | CA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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