Organization
DENTAL SURGERY CENTERS OF AMERICA
Active
Other names
Central California Dental Surgery Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DEVIN LARSEN (CEO)
(208) 340-1840
Entity
Organization
Contact information
Practice address
3605 HOSPITAL ROAD, SUITE H, ATWATER, CA 95301-5173
(209) 381-2047
(209) 381-2045
Mailing address
1523 EAST MARCH LANE, SUITE A, STOCKTON, CA 95210-5607
(209) 952-9000
(209) 373-1190
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
040000485
CA
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Enumeration date
10/05/2006
Last updated
05/30/2024
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