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Organization
EZE DENTAL PROFESSIONAL CORPORATION
Active
Organization
EZE DENTAL PROFESSIONAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KENECHUKWU EZE DDS (OWNER DENTIST)
(916) 500-5437
Entity
Organization
Contact information
Practice address
6030 S LAND PARK DR, SACRAMENTO, CA 95822-3315
(916) 500-5437
(916) 244-7004
Mailing address
6030 S LAND PARK DR, SACRAMENTO, CA 95822-3315
(916) 500-5437
(916) 244-7004
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
—
—
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
56954
DENTIST
CA
Enumeration date
08/14/2021
Last updated
08/14/2021
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