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Organization
MISSION DENTAL
Active
Organization
MISSION DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. JULIE ANN DAY (EXECUTIVE DIRECTOR)
(916) 837-7174
Entity
Organization
Contact information
Practice address
1166 BROADWAY STE J, PLACERVILLE, CA 95667-5754
(530) 626-8626
Mailing address
PO BOX 1043, PLACERVILLE, CA 95667-1043
(530) 626-8626
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
03/02/2015
Last updated
08/06/2015
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