Healthcare Provider Details
I. General information
NPI: 1528433885
Provider Name (Legal Business Name): MICHAEL FRENCH DDS DENTAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 12/11/2015
Last Update Date: 12/11/2015
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
800 MORNINGSTAR DR
SONORA CA
95370
US
IV. Provider business mailing address
800 MORNING STAR DR
SONORA CA
95370-9260
US
V. Phone/Fax
- Phone: 209-588-8400
- Fax: 209-588-8811
- Phone: 209-588-8400
- Fax: 209-588-8811
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 282NC2000X |
| Taxonomy | Children's Hospital |
| License Number | 72844 |
| License Number State | CA |
VIII. Authorized Official
Name: DR.
MICHAEL
LOUIS
FRENCH
Title or Position: OWNER
Credential: DDS
Phone: 209-588-8400