Organization
BROCK HINTON DDS, INC
Active
Other names
Prosthodontic Dental Group
Organization subpart
No
Provider details
NPI number
Authorized official
JADGEV HEIR (CEO/PRESIDENT)
(518) 441-5483
Entity
Organization
Contact information
Practice address
5252 SUNRISE BLVD, SUITE #2, FAIR OAKS, CA 95628
(916) 454-0860
Mailing address
4170 TRUXEL ROAD, SUITE C, SACRAMENTO, CA 95834
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
—
—
1223P0300X
Periodontics
—
—
1223P0700X
Prosthodontics
Primary
—
—
Other
Enumeration date
07/25/2023
Last updated
07/25/2023
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