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Organization
FAMILY DENTAL PRACTICE OF ROSEVILLE
Active
Organization
FAMILY DENTAL PRACTICE OF ROSEVILLE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARK D PHIPPS D.D.S. (OWNER)
(916) 773-4343
Entity
Organization
Contact information
Practice address
4014 FOOTHILLS BLVD, SUITE 103, ROSEVILLE, CA 95747-7233
(916) 773-4343
(916) 773-4348
Mailing address
4014 FOOTHILLS BLVD, SUITE 103, ROSEVILLE, CA 95747-7233
(916) 773-4343
(916) 773-4348
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
29786
CA
Other
Enumeration date
03/08/2007
Last updated
08/22/2020
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