Organization
MOUNTAIN COMMUNITIES HEALTHCARE DIS
Active
Other names
Trinity Community Dental Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
MS. ALETHEA HIGGINS (DIRECTOR REVENUE CYCLE)
(530) 623-5541
Entity
Organization
Contact information
Practice address
121 BARBARA AVENUE, WEAVERVILLE, CA 96093
(530) 623-5541
(530) 623-6421
Mailing address
P.O, BOX 1229, 60 EASTER AVENUE, WEAVERVILLE, CA 96093-1229
(530) 623-5541
(530) 623-6421
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
230000038
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
RHC08618F
—
CA
Enumeration date
10/18/2006
Last updated
05/08/2013
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