Organization
DOWNTOWN DENTAL BENICA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JACK ALLEN ELDER D.D.S. (PRESIDENT)
(707) 745-3820
Entity
Organization
Contact information
Practice address
172 EAST D STREET, BENICIA, CA 94510
(707) 745-3820
Mailing address
172 EAST D STREET, BENICIA, CA 94510
(707) 745-3820
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
07/27/2009
Last updated
07/27/2009
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