Provider Demographics
NPI:1821804170
Name:T. RUTNER DDS DENTAL CORPORATION
Entity type:Organization
Organization Name:T. RUTNER DDS DENTAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MARIBEL
Authorized Official - Middle Name:
Authorized Official - Last Name:GARCIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:530-677-3788
Mailing Address - Street 1:493 MAIN ST STE C
Mailing Address - Street 2:
Mailing Address - City:DIAMOND SPRINGS
Mailing Address - State:CA
Mailing Address - Zip Code:95619-9173
Mailing Address - Country:US
Mailing Address - Phone:530-344-0290
Mailing Address - Fax:530-344-0291
Practice Address - Street 1:6400 PLEASANT VALLEY RD
Practice Address - Street 2:
Practice Address - City:EL DORADO
Practice Address - State:CA
Practice Address - Zip Code:95623-4230
Practice Address - Country:US
Practice Address - Phone:530-344-0290
Practice Address - Fax:530-344-0291
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:T. RUTNER DDS DENTAL CORPORATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-12-10
Last Update Date:2025-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty