TIMOTHY E MICKIEWICZ DENTAL CORPORATION
Managed Care Organizations at Folsom Blvd, Sacramento, CA

License number
California 30810
Category
Managed Care Organizations
Type
Preferred Provider Organization
Owner
Name: TIMOTHY MICKIEWICZ DDS
Title: DENTIST
Phone: (916) 457-7710
Address
Address
3401 Folsom Blvd SUITE A, Sacramento, CA 95816
National Provider ID: 1558668244
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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TIMOTHY E. MICKIEWICZ DENTAL CORPORATION

3401 Folsom Blvd STE A, Sacramento, CA 95816

Industry:
Dentists, Oral Surgeons
Doing business as:
Timothy E Mickiewicz DDS
Registration:
Jun 6, 1988
Phone:
(916) 457-7710 (Phone)
Description:
There is 1 doctor at this site. Surgery is not performed at this site.
State ID:
C1616038
Business type:
Articles of Incorporation
President:
Timothy E. Mickiewicz (President)
Agent:
Timothy E Mickiewicz,Sacramento, CA 95816 (Physical)

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