# AMEZCUA DENTAL CORPORATION

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- **Entity:** Organization
- **Status:** Active
- **Other names:** MARKET WEST DENTAL GROUP
- **Organization subpart:** No

## Provider details

- **NPI number:** 1679666432
- **Authorized official:** DR. OSVALDO AMEZCUA DDS (OWNER DDS)
- **Authorized official phone:** (916) 574-9400

## Contact information

- **Practice address:** 3290 ARENA BLVD, STE. 610, SACRAMENTO, CA 95834-3003
- **Practice address phone:** (916) 574-9400
- **Practice address fax:** (916) 574-9494
- **Mailing address:** PO BOX 920050, DALLAS, TX 75392-0050
- **Mailing address phone:** (714) 508-3600
- **Mailing address fax:** (714) 368-2092

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | — | — | Yes |

## Other

- **Enumeration date:** 10/02/2006
- **Last updated:** 05/11/2022