Organization
DIAMOND SPRINGS 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
540 MAIN STREET, STE. 102 POST OFFICE BOX 500, DIAMOND SPRINGS, CA 95619-0500
(530) 344-0290
(530) 344-0291
Mailing address
PO BOX 500, STE. 102, DIAMOND SPRINGS, CA 95619-0500
(530) 344-0290
(530) 344-0291
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D43010
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
130082
UMITED CONCORDIA
CA
Enumeration date
01/23/2009
Last updated
10/04/2010
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