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General NPI Number Information
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NPI Number | 1083373096
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Entity Type | Organization
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Legal Business Name | SCRIPPS FAMILY DENTAL PARTNERSHIP
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Dates
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Enumeration Date | 12/17/2021
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Last Update Date | 12/17/2021
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Provider Practice Location Address
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Address Line | 103 SCRIPPS DR STE 8
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City | SACRAMENTO
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State | CA
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Zip | 95825-6316
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Country | US
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Telephone | 916-929-1156
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Fax |
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Provider Business Mailing Address
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Address Line | 103 SCRIPPS DR STE 8
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City | SACRAMENTO
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State | CA
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Zip | 95825-6316
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Country | US
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Telephone | 916-929-1156
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Fax |
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Authorized Official
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Title or Position | OWNER PARTNER DENTIST
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Name | DR. SANDRA LYNN FOULADI
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Credential | DDS
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Telephone | 310-889-4784
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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