Provider Demographics
NPI:1720436629
Name:S.DINTCHO DDS CCM INC.
Entity Type:Organization
Organization Name:S.DINTCHO DDS CCM INC.
Other - Org Name:APTOS CCM
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:STANLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:DINTCHO
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:415-922-3886
Mailing Address - Street 1:2250 UNION ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94123-3900
Mailing Address - Country:US
Mailing Address - Phone:415-922-3886
Mailing Address - Fax:415-922-3895
Practice Address - Street 1:2250 UNION ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94123-3900
Practice Address - Country:US
Practice Address - Phone:415-922-3886
Practice Address - Fax:415-922-3895
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-01
Last Update Date:2016-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA23496302F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302F00000XManaged Care OrganizationsExclusive Provider Organization