# BROCK HINTON DDS, INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Prosthodontic Dental Group
- **Organization subpart:** No

## Provider details

- **NPI number:** 1295415123
- **Authorized official:** JADGEV HEIR (CEO/PRESIDENT)
- **Authorized official phone:** (518) 441-5483

## Contact information

- **Practice address:** 5252 SUNRISE BLVD, SUITE \#2, FAIR OAKS, CA 95628
- **Practice address phone:** (916) 454-0860
- **Mailing address:** 4170 TRUXEL ROAD, SUITE C, SACRAMENTO, CA 95834

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | — | — | — |
| 1223P0300X | Periodontics | — | — | — |
| 1223P0700X | Prosthodontics | — | — | Yes |

## Other

- **Enumeration date:** 07/25/2023
- **Last updated:** 07/25/2023