Organization
WELLSPACE HEALTH
Active
Other names
WellSpace Health Galt Dental Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
ALASDAIR JONATHAN PORTEUS PHD (CHIEF EXECUTIVE OFFICER)
(916) 550-5444
Entity
Organization
Contact information
Practice address
216 N LINCOLN WAY STE 10, GALT, CA 95632-1715
(209) 259-2090
(209) 259-3008
Mailing address
1500 EXPO PKWY, SACRAMENTO, CA 95815-4227
(916) 469-4705
(916) 880-5552
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
261QF0400X
Federally Qualified Health Center (FQHC)
—
—
Other
Enumeration date
10/09/2017
Last updated
03/13/2024
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