Ask, Kinzer, Simpson, and Roda a Professional Dental Corp
Organization Active NPI Periodontics · Jackson, CA
NPI 1992958755 · NPPES record last updated Oct 24, 2008
Key facts
- NPI
- 1992958755
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Periodontics 1223P0300X
- License
- B20858 (CA)
- Legal business name
- ASK, KINZER, SIMPSON, AND RODA A PROFESSIONAL DENTAL CORP
- Practice address
- 100 French Bar Rd
Suite 103
Jackson, CA 95642-2557 - Phone
- (209) 223-3502
- Fax
- (209) 223-3562
- NPI assigned
- Oct 24, 2008
- Organization subpart
- No
Authorized official
- Name
- Dr. Ronney Mihran Ask, D.D.S.
- Title
- Chief Financial Officer
- Phone
- (209) 223-2096
Corporate family (same tax ID) 1
National Provider Directory
- Tax ID family
- Amador Dental Specialties
Locations
100 French Bar Rd
Ste 103
Jackson, CA 95642
Phone (209) 223-3502
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Periodontics |
1223P0300X | B20858 | CA | Yes |
Addresses
Primary practice location
100 French Bar Rd
Suite 103
Jackson, CA 95642-2557
Mailing address
100 French Bar Rd
Suite 103
Jackson, CA 95642-2557
Phone (209) 223-3502
Other names
- Amador Dental Specialties
Other providers in Jackson, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 24, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.