Provider Demographics
NPI:1275090946
Name:ATKINSON DENTAL CORPORATION
Entity Type:Organization
Organization Name:ATKINSON DENTAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:STANLEY
Authorized Official - Middle Name:WAYNE
Authorized Official - Last Name:ATKINSON
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:831-484-5294
Mailing Address - Street 1:25339 CAMINO DE CHAMISAL
Mailing Address - Street 2:
Mailing Address - City:SALINAS
Mailing Address - State:CA
Mailing Address - Zip Code:93908-8927
Mailing Address - Country:US
Mailing Address - Phone:831-484-5204
Mailing Address - Fax:
Practice Address - Street 1:25339 CAMINO DE CHAMISAL
Practice Address - Street 2:
Practice Address - City:SALINAS
Practice Address - State:CA
Practice Address - Zip Code:93908-8927
Practice Address - Country:US
Practice Address - Phone:831-484-5204
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-28
Last Update Date:2019-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental