# COMMUNITY DENTAL SURGERY CENTER

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

## Provider details

- **NPI number:** 1427223544
- **Authorized official:** MR. MARCUS S. KASPRZYK (ADMINISTRATOR)
- **Authorized official phone:** (209) 602-0212

## Contact information

- **Practice address:** 1523 E MARCH LN, SUITE 100, STOCKTON, CA 95310-5600
- **Practice address phone:** (209) 602-0212
- **Mailing address:** 1523 E MARCH LN, SUITE 100, STOCKTON, CA 95210-5600
- **Mailing address phone:** (209) 602-0201

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QA1903X | Ambulatory Surgical Clinic/Center | G58822 | CA | Yes |

## Other

- **Enumeration date:** 04/29/2008
- **Last updated:** 04/29/2008