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Organization
PLEASANT VALLEY DENTAL
Active
Organization
PLEASANT VALLEY DENTAL
Active
Other names
Pleasant Valley Dental, General Dental Practice of Mitchell A. Goodis,
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MITCHELL A GOODIS DDS (DENTIST)
(530) 344-0290
Entity
Organization
Contact information
Practice address
6400 PLEASANT VALLEY RD, EL DORADO, CA 95623-4230
(530) 622-2862
(530) 622-2072
Mailing address
PO BOX 568, EL DORADO, CA 95623-0568
(530) 622-2862
(530) 622-2072
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D43010
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1854195417
NPI FROM PRIMARY OFFICE AT DIAMOND SPRINGS DENTAL CENTER
CA
Enumeration date
12/18/2008
Last updated
09/28/2010
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