Organization · Type 2 NPI
Your Great Smile,inc. A Dental Hygiene Practice of Vange Leonis, Rdhap
Dental Clinic/Center · Rio Vista, CA
NPI number
1679072417
Active
Practice location
900 Saint Andrews Dr
Rio Vista, CA 94571-9707
Fax (415) 898-7389
Mailing address
926A Diablo Ave # 122
Novato, CA 94947-4025
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Dental Clinic/Center Primary | 261QD0000X | HAP47 (CA) |
Dental Clinic/Center: Definition to come...
About NPI 1679072417
Your Great Smile,inc. A Dental Hygiene Practice of Vange Leonis, Rdhap's National Provider Identifier is 1679072417, issued on Feb 7, 2018. The primary taxonomy on file is Dental Clinic/Center (261QD0000X), and the practice location is in Rio Vista, CA. The record was last updated on Feb 7, 2018.