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Organization
NOVA TELEDENTISTRY
Active
Organization
NOVA TELEDENTISTRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROXANNE ROCCANOVA (FOUNDER)
(916) 540-0737
Entity
Organization
Contact information
Practice address
8111 AZTEC WAY, ANTELOPE, CA 95843-4411
(916) 540-0737
Mailing address
7451 AUBURN BLVD STE C, CITRUS HEIGHTS, CA 95610-2992
Taxonomy
Speciality
Code
Description
License number
State
1223D0001X
Public Health Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
D5352890
DL
CA
Enumeration date
06/13/2022
Last updated
06/13/2022
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