Provider Demographics
NPI:1043925746
Name:ALMAZ, DDS, PC
Entity Type:Organization
Organization Name:ALMAZ, DDS, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ELIAS
Authorized Official - Middle Name:C
Authorized Official - Last Name:ALMAZ
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:916-791-4646
Mailing Address - Street 1:7005 BOARDWALK DR STE 100
Mailing Address - Street 2:
Mailing Address - City:GRANITE BAY
Mailing Address - State:CA
Mailing Address - Zip Code:95746-9203
Mailing Address - Country:US
Mailing Address - Phone:916-791-4646
Mailing Address - Fax:916-791-5247
Practice Address - Street 1:7005 BOARDWALK DR STE 100
Practice Address - Street 2:
Practice Address - City:GRANITE BAY
Practice Address - State:CA
Practice Address - Zip Code:95746-9203
Practice Address - Country:US
Practice Address - Phone:916-791-4646
Practice Address - Fax:916-791-5247
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-17
Last Update Date:2023-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA102579OtherDENTAL LICENSE