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Organization
SHASTA COMMUNITY HEALTH CENTER
Active
Organization
SHASTA COMMUNITY HEALTH CENTER
Active
Parent organization
SHASTA COMMUNITY HEALTH CENTER
Other names
Shasta Community Dental Clinic
Organization subpart
Yes
Provider details
NPI number
Legal business name
SHASTA COMMUNITY HEALTH CENTER
Authorized official
MR. JEFFERY BRANDON THORNOCK (CEO)
(530) 246-5710
Entity
Organization
Contact information
Practice address
1201 INDUSTRIAL ST, REDDING, CA 96002-0757
(530) 246-5894
(530) 241-7838
Mailing address
PO BOX 992790, REDDING, CA 96099-2790
(530) 246-5894
(530) 241-7838
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
230000297
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
FHC70840F
SCHCDENTAL MEDI-CAL NO
CA
Enumeration date
07/25/2006
Last updated
10/14/2024
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