Capitol Periodontal Group
NPI #1366908618 in Davis, California
Provider Information
- NPI Number
- 1366908618
- Entity Type
- Organization
- Organization Name
- Capitol Periodontal Group
- Primary Specialty
- Dentist - Periodontics
- Enumeration Date
- Feb 12, 2019
- Last Updated
- Feb 12, 2019
Practice Location
- Address
- 750 F STREET #5
- City
- Davis
- State
- California
- ZIP Code
- 95616
- Phone
- (530) 756-6087
Authorized Official
- Name
- RENEE BLAKE
- Title
- INSURANCE COORDINATOR
- Phone
- (916) 691-1050
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist - Periodontics — Periodontics |
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