Organization
PHEN DENTAL PROFESSIONAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER PHEN (OFFICE MANAGER)
(916) 337-5158
Entity
Organization
Contact information
Practice address
109 FERRARI RANCH RD STE 100, LINCOLN, CA 95648-7423
(916) 253-7000
Mailing address
109 FERRARI RANCH RD STE 100, LINCOLN, CA 95648-7423
(916) 253-7000
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
05/25/2021
Last updated
05/25/2021
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