Organization · Type 2 NPI

Colusa Indian Community Council

Dental Clinic/Center · Colusa, CA

NPI number 1053880245 Active

Practice location

360 5th St
Colusa, CA 95932-2467

Call (530) 458-3614 Map

Fax (530) 458-4047

Mailing address

3710 Highway 45
Colusa, CA 95932-4026

Specialties and licenses

Taxonomy	Code	License
Dental Clinic/Center Primary	261QD0000X	None listed

Dental Clinic/Center: Definition to come...

5 other providers at this address

NPI record

NPI: 1053880245
Entity type: Organization (Type 2)
Issued: Nov 16, 2018
Last updated: Nov 16, 2018
Status: Active
Subpart: Yes of Colusa Indian Community Council

Other names

Colusa Indian Dental Clinic · doing business as

Authorized official

Catrina Marie Ross
Director of Clinic Operations
(530) 458-6542

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This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1053880245

Colusa Indian Community Council's National Provider Identifier is 1053880245, issued on Nov 16, 2018. The primary taxonomy on file is Dental Clinic/Center (261QD0000X), and the practice location is in Colusa, CA. The record was last updated on Nov 16, 2018.