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NPI Code Detail

MEDICARE: VALLE SMILES

MEDICARE: VALLE SMILES
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
1122300000XDentist

General Provider Information

NPI Number : 1437634532
Entity Type Code : Organization
Provider Name (Legal Business Name) : VALLE SMILES
Provider Business Mailing Address
First Line : 3075 BEACON BLVD
Second Line :
City : WEST SACRAMENTO
State : CA
Zip : 95691-3462
Country : US
Telephone Number : 916-702-1213
Fax Number : 916-384-3844
Provider Business Practice Location Address
First Line : 2990 W GRANT LINE RD
Second Line :
City : TRACY
State : CA
Zip : 95304-7901
Country : US
Telephone Number : 209-830-7797
Fax Number : 916-384-3844
Authorized Official
Title or Position : OWNER
Name : DR. YAN KALIKA
Credential : DDS
Telephone Number : 916-702-1213
Provider Enumeration Date : 09/25/2018
Last Update Date : 10/30/2018

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Directions to “VALLE SMILES ” Practice Location

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