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General NPI Number Information
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NPI Number | 1083801765
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Entity Type | Organization
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Legal Business Name | NEW DENTAL IMAGES
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Dates
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Enumeration Date | 09/26/2007
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Last Update Date | 09/26/2007
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Provider Practice Location Address
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Address Line | 6624 VALLEY HI DR
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City | SACRAMENTO
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State | CA
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Zip | 95823-4602
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Country | US
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Telephone | 916-688-1990
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Fax | 916-688-5467
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Provider Business Mailing Address
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Address Line | PO BOX 231248
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City | SACRAMENTO
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State | CA
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Zip | 95823-0404
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Country | US
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Telephone | 916-688-1990
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Fax | 916-688-5467
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Authorized Official
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Title or Position | OWNER/DOCTOR
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Name | MRS. VAN NGOC DANG
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Credential | DDS
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Telephone | 916-688-1990
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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 | 50134
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License Number State | CA
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