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General NPI Number Information
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NPI Number | 1831470962
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Entity Type | Organization
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Legal Business Name | STEELE SACRAMENTO VALLEY DENTAL GRO
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Dates
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Enumeration Date | 09/02/2011
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Last Update Date | 09/02/2011
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Provider Practice Location Address
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Address Line | 1115 12TH ST SUITE 2A
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City | SACRAMENTO
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State | CA
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Zip | 95814-3903
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Country | US
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Telephone | 916-443-4430
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Fax | 916-443-5836
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Provider Business Mailing Address
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Address Line | 1115 12TH ST SUITE 2A
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City | SACRAMENTO
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State | CA
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Zip | 95814-3903
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Country | US
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Telephone | 916-443-4430
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Fax | 916-443-5836
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. BRIAN CAMERON STEELE
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Credential | DDS
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Telephone | 916-443-4430
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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 | 54818
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License Number State | CA
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