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Organization
NORTHSTATE DENTAL
Active
Organization
NORTHSTATE DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ALVIN CHEUNG PHARMD (PRESIDENT/CEO)
(916) 216-6202
Entity
Organization
Contact information
Practice address
2400 MARITIME DRIVE, ELK GROVE, CA 95758
(916) 686-8914
Mailing address
9700 W TARON DRIVE, ELK GROVE, CA 95757
(916) 686-7300
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
10/11/2023
Last updated
10/11/2023
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