Provider Demographics
NPI:1326063561
Name:DAVID A CAIN DDS, MSD A PROFESSIONAL CORPORATION
Entity Type:Organization
Organization Name:DAVID A CAIN DDS, MSD A PROFESSIONAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:ALAN
Authorized Official - Last Name:CAIN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS, MSD
Authorized Official - Phone:925-756-6158
Mailing Address - Street 1:34532 HILLCREST AVE.
Mailing Address - Street 2:SUITE 225
Mailing Address - City:ANTIOCH
Mailing Address - State:CA
Mailing Address - Zip Code:94531
Mailing Address - Country:US
Mailing Address - Phone:925-756-6158
Mailing Address - Fax:925-756-2852
Practice Address - Street 1:3432 HILLCREST AVE
Practice Address - Street 2:SUITE 225
Practice Address - City:ANTIOCH
Practice Address - State:CA
Practice Address - Zip Code:94531-8238
Practice Address - Country:US
Practice Address - Phone:925-756-6158
Practice Address - Fax:925-756-2852
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-12
Last Update Date:2012-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA385001223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty