Individual
MR. DALE ANTHONY BETTENCOURT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RD
Contact information
Practice address
6600 BRUCEVILLE RD, SACRAMENTO, CA 95823-4671
(916) 968-5079
Mailing address
6600 BRUCEVILLE RD, SACRAMENTO, CA 95823-4671
Taxonomy
Speciality
Code
Description
License number
State
132700000X
Dietary Manager
Primary
1033537
CA
Other
Enumeration date
05/13/2016
Last updated
12/17/2021
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