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General NPI Number Information
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NPI Number | 1780878538
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Entity Type | Organization
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Legal Business Name | CAMINO RAMON DENTAL
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Dates
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Enumeration Date | 09/04/2007
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Last Update Date | 09/04/2007
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Provider Practice Location Address
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Address Line | 2301 CAMINO RAMON SUITE 240
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City | SAN RAMON
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State | CA
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Zip | 94583-4440
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Country | US
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Telephone | 925-830-0888
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Fax | 925-830-0988
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Provider Business Mailing Address
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Address Line | 2301 CAMINO RAMON SUITE 240
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City | SAN RAMON
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State | CA
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Zip | 94583-4440
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Country | US
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Telephone | 925-830-0888
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Fax | 925-830-0988
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MISS ASHLEY HARRIS
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Credential |
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Telephone | 925-830-0888
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 305R00000X
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Taxonomy Name | Preferred Provider Organization
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License Number | 50281
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 305R00000X
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Taxonomy Name | Preferred Provider Organization
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License Number | 50298
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License Number State | CA
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