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Organization
MANTENA DENTAL CORPORTATION
Active
Organization
MANTENA DENTAL CORPORTATION
Active
Other names
Empire Parkway Dental Group
Organization subpart
No
Provider details
NPI number
Authorized official
MORGAN MACDOUGALL (OFFICE MANAGER)
(916) 599-6767
Entity
Organization
Contact information
Practice address
25005 BLUE RAVINE RD STE 100, FOLSOM, CA 95630-5706
(916) 984-8050
Mailing address
25005 BLUE RAVINE RD STE 100, FOLSOM, CA 95630-5706
(916) 984-8050
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
07/16/2020
Last updated
07/16/2020
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