# UNIVERSITY CALIFORNIA DAVIS MEDICAL CENTER, UNIVERSITY DENTAL ASSOC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1316944465
- **Authorized official:** DR. ROBERT LYONS DDS (DIRECTOR DENTAL CLINIC)
- **Authorized official phone:** (916) 734-5408

## Contact information

- **Practice address:** 2521 STOCKTON BLVD, SACRAMENTO, CA 95817-2207
- **Practice address phone:** (916) 734-5408
- **Practice address fax:** (916) 734-1299
- **Mailing address:** 2521 STOCKTON BLVD, SACRAMENTO, CA 95817-2207
- **Mailing address phone:** (916) 734-5408
- **Mailing address fax:** (916) 734-1299

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223P0700X | Prosthodontics | 23361 | CA | Yes |

## Other

- **Enumeration date:** 07/05/2005
- **Last updated:** 08/22/2020