MEDICARE: GILBERT S LIMHENGCO, DMD, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	39033	CA

General Provider Information

NPI Number	:	1003925645
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GILBERT S LIMHENGCO, DMD, INC.

Provider Business Mailing Address
First Line	:	6024 SAN JUAN AVE
Second Line	:	SUITE C
City	:	CITRUS HEIGHTS
State	:	CA
Zip	:	95610-5643
Country	:	US
Telephone Number	:	916-728-2888
Fax Number	:	916-728-2818

Provider Business Practice Location Address
First Line	:	6024 SAN JUAN AVE
Second Line	:	SUITE C
City	:	CITRUS HEIGHTS
State	:	CA
Zip	:	95610-5643
Country	:	US
Telephone Number	:	916-728-2888
Fax Number	:	916-728-2818

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. GILBERT S LIMHENGCO
Credential	:	DMD
Telephone Number	:	916-728-2888

Provider Enumeration Date	:	08/29/2006
Last Update Date	:	03/25/2010

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