is a Preferred Provider Organization in , . practices all healthcare services and medical treatments related to Preferred Provider Organization. The NPI Number for is 1730291832. The last update date is .
's current location address is , , . You can contact this provider via phone number . The mailing address for is , , . To know further, please read the information below!
Provider Profile Detail
| Provider Name | |
|---|---|
| Address | , , |
| Phone Number | |
| Fax Number | |
| Sole Proprietor | -- |
| Credentials | -- |
NPI Number Detail
| NPI Number | 1730291832 |
|---|---|
| Provider Enumeration Date | |
| Last Updated Date |
Provider Mailing Address Detail
| Address | |
|---|---|
| City | |
| State | () |
| Post Code | |
| Phone Number | |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Preferred Provider Organization |
|---|---|
| Taxonomy | 305R00000X |
| Licence No | 45212 |
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Definition: A group of physicians and/or hospitals who contract with an employer to provide services to their employees. In a PPO, the patient may got to the physician of his/her choice, even if that physician does not participate in the PPO, but the patient rec |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| B4521201 | CA | DENTI-CAL ID NUM | |
| 45212 | CA | DENTAL LICENCE |
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