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Organization
DENTRUST, P.C.
Active
Organization
DENTRUST, P.C.
Active
Other names
DOCS Dental Travis AFB
Organization subpart
No
Provider details
NPI number
Authorized official
AMANDA EVANS LANCE (CREDENTIALING SPECIALIST)
(910) 728-9767
Entity
Organization
Contact information
Practice address
461 SKYMASTER CIR BLDG 648, TRAVIS AFB, CA 94535-1909
(707) 474-4599
(707) 402-6535
Mailing address
461 SKYMASTER CIR BLDG 648, TRAVIS AFB, CA 94535-1909
(707) 474-4599
(707) 402-6535
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
05/03/2022
Last updated
09/01/2022
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