Organization
VAN SICKLEN DDS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHARLES NEAL VAN SICKLEN DDS (CEO)
(209) 607-6956
Entity
Organization
Contact information
Practice address
1372 W ROBINHOOD DR STE A, STOCKTON, CA 95207-5513
(209) 607-6956
Mailing address
9591 RUFF AVE, STOCKTON, CA 95212-2417
(209) 607-6956
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
06/26/2021
Last updated
07/14/2021
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