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General NPI Number Information
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NPI Number | 1245645506
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Entity Type | Organization
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Legal Business Name | SHEILS DENTAL CARE INC
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Dates
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Enumeration Date | 06/25/2014
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Last Update Date | 09/18/2014
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Provider Practice Location Address
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Address Line | 8211 SIERRA COLLEGE BLVD STE 404
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City | ROSEVILLE
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State | CA
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Zip | 95661-9405
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Country | US
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Telephone | 916-773-9300
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Fax |
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Provider Business Mailing Address
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Address Line | 8211 SIERRA COLLEGE BLVD STE 404
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City | ROSEVILLE
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State | CA
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Zip | 95661-9405
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Country | US
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Telephone |
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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. RICHARD G SHEILS
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Credential |
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Telephone | 916-773-9300
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332BC3200X
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Taxonomy Name | Customized Equipment (DME)
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License Number | 034420
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License Number State | CA
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