Organization
TERRY L. VINCENT, DDS, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TERRY LEE VINCENT D.D.S. (PRESIDENT)
(831) 596-6395
Entity
Organization
Contact information
Practice address
136 HIDDEN VALLEY RD, ROYAL OAKS, CA 95076-9271
(831) 596-6395
Mailing address
136 HIDDEN VALLEY RD, ROYAL OAKS, CA 95076-9271
(831) 596-6395
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
22558
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
22558
DENTAL LICENSE NUMBER
CA
Enumeration date
08/31/2010
Last updated
08/31/2010
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