Healthcare Provider Details

I. General information

NPI: 1194916411
Provider Name (Legal Business Name): DAVID N ARNOLD, D.D.S.,P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/05/2007
Last Update Date: 08/05/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1250 OAK CIRCLE
ARNOLD CA
95223
US

IV. Provider business mailing address

PO BOX 687
ARNOLD CA
95223-0687
US

V. Phone/Fax

Practice location:
  • Phone: 209-795-1334
  • Fax:
Mailing address:
  • Phone: 209-795-1334
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number24741
License Number StateCA

VIII. Authorized Official

Name: DAVID N ARNOLD
Title or Position: OWNER/DENTIST
Credential:
Phone: 209-795-1334