Organization
ON-SITE DENTAL CARE FOUNDATION, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHERYL MARTINE WALTER (EXECUTIVE DIRECTOR)
(408) 315-4864
Entity
Organization
Contact information
Practice address
3180 NEWBERRY DR STE 200, SAN JOSE, CA 95118-1566
(408) 315-4864
(408) 608-2205
Mailing address
PO BOX 41111, SAN JOSE, CA 95160-1111
(408) 315-4864
(408) 608-2205
Taxonomy
Speciality
Code
Description
License number
State
1223D0001X
Public Health Dentistry
Primary
—
—
124Q00000X
Dental Hygienist
—
—
126800000X
Dental Assistant
—
—
Other
Enumeration date
04/18/2018
Last updated
04/18/2018
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