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Organization
WELLSPACE HEALTH
Active
Organization
WELLSPACE HEALTH
Active
Other names
WellSpace Health Galt Dental Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
ALASDAIR JONATHAN PORTEUS PHD (CHIEF EXECUTIVE OFFICER)
(916) 550-5444
Entity
Organization
Contact information
Practice address
216 N LINCOLN WAY STE 10, GALT, CA 95632-1715
(209) 259-2090
(209) 259-3008
Mailing address
1500 EXPO PKWY, SACRAMENTO, CA 95815-4227
(916) 469-4705
(916) 880-5552
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
261QF0400X
Federally Qualified Health Center (FQHC)
—
—
Other
Enumeration date
10/09/2017
Last updated
03/13/2024
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