Provider Demographics
NPI:1427183862
Name:MOLINA, DAVID GREGORY (DDS)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:GREGORY
Last Name:MOLINA
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11010 COMBIE RD STE 208
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:CA
Mailing Address - Zip Code:95602-8948
Mailing Address - Country:US
Mailing Address - Phone:530-268-1445
Mailing Address - Fax:530-268-0701
Practice Address - Street 1:11010 COMBIE RD STE 208
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:CA
Practice Address - Zip Code:95602-8948
Practice Address - Country:US
Practice Address - Phone:530-268-1445
Practice Address - Fax:530-268-0701
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA290871223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice