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NPI Code Detail

MEDICARE: MILL ROCK ORAL SURGERY DENTAL GROUP

MEDICARE: MILL ROCK ORAL SURGERY DENTAL GROUP
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
1261QD0000XDental Clinic/Center

General Provider Information

NPI Number : 1811155609
Entity Type Code : Organization
Provider Name (Legal Business Name) : MILL ROCK ORAL SURGERY DENTAL GROUP
Provider Business Mailing Address
First Line : 1601 MILL ROCK WAY # A
Second Line :
City : BAKERSFIELD
State : CA
Zip : 93311-1315
Country : US
Telephone Number : 661-847-0065
Fax Number : 661-847-0068
Provider Business Practice Location Address
First Line : 1601 MILL ROCK WAY # A
Second Line :
City : BAKERSFIELD
State : CA
Zip : 93311-1315
Country : US
Telephone Number : 661-847-0065
Fax Number : 661-847-0068
Authorized Official
Title or Position : OWNER
Name : DR. ANTHONY G. CHING
Credential : DDS
Telephone Number : 661-847-0065
Provider Enumeration Date : 05/28/2008
Last Update Date : 06/25/2008

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Directions to “MILL ROCK ORAL SURGERY DENTAL GROUP ” Practice Location

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