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NPI Code Detail

MEDICARE: POK TEH DMD

MEDICARE: POK TEH DMD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223G0001XGeneral Practice Dentistry54505CA

General Provider Information

NPI Number : 1013081025
Entity Type Code : Individual
Provider Name (Legal Business Name) : POK TEH DMD
Provider Business Mailing Address
First Line : 2833 MARCONI AVE
Second Line :
City : SACRAMENTO
State : CA
Zip : 95821-5264
Country : US
Telephone Number : 916-972-1751
Fax Number :
Provider Business Practice Location Address
First Line : 2833 MARCONI AVE
Second Line :
City : SACRAMENTO
State : CA
Zip : 95821-5264
Country : US
Telephone Number : 916-972-1751
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/20/2006
Last Update Date : 05/07/2016

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Directions to “ POK TEH DMD” Practice Location

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