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General NPI Number Information
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NPI Number | 1205646478
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Entity Type | Organization
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Legal Business Name | FOLSOM SPECIALTIES DENTAL GROUP INC
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Dates
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Enumeration Date | 01/09/2025
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Last Update Date | 01/09/2025
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Provider Practice Location Address
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Address Line | 9121 FOLSOM BLVD STE B
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City | SACRAMENTO
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State | CA
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Zip | 95826-2473
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Country | US
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Telephone | 916-362-9755
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Fax |
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Provider Business Mailing Address
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Address Line | 8880 CAL CENTER DR
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City | SACRAMENTO
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State | CA
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Zip | 95826-3222
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Country | US
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Telephone | 818-644-0542
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ARMEN JOSEPH PEZESHKIAN
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Credential | DDS
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Telephone | 818-644-0542
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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