Provider Demographics
NPI:1336277268
Name:APPLE PERIODONTICS & DENTAL IMPLANTS
Entity Type:Organization
Organization Name:APPLE PERIODONTICS & DENTAL IMPLANTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DOREL
Authorized Official - Middle Name:
Authorized Official - Last Name:ONEA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:916-789-1222
Mailing Address - Street 1:4300 LIVE OAK LN #A
Mailing Address - Street 2:
Mailing Address - City:ROCKLIN
Mailing Address - State:CA
Mailing Address - Zip Code:95765-2925
Mailing Address - Country:US
Mailing Address - Phone:916-789-1222
Mailing Address - Fax:916-367-7901
Practice Address - Street 1:4300 LIVE OAK LN #A
Practice Address - Street 2:
Practice Address - City:ROCKLIN
Practice Address - State:CA
Practice Address - Zip Code:95765-2925
Practice Address - Country:US
Practice Address - Phone:916-789-1222
Practice Address - Fax:916-367-7901
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-01
Last Update Date:2008-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CACA45743122300000X
CA261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental
No122300000XDental ProvidersDentistGroup - Multi-Specialty