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NPI 1639174279

OrganizationActive

A Professional Dental Corp.

NPI 1639174279 · Periodontics · Antioch, CA

Provider details

NPI number: 1639174279
Entity type: Organization
Primary specialty: PeriodonticsDental Providers
Authorized official: Kelly Butti, Office Manager
License: 40072 (CA)

Practice location

3505 Lone Tree Way

Ste 7

Antioch, CA 94509-6067

Phone: (925) 756-7884

Fax: (925) 756-7894

More CA providers

Mailing address

3505 Lone Tree Way

Antioch, CA 94509-6067

Registry dates

Enumerated: 2005-06-20
Last updated: 2008-06-13

Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.

A Professional Dental Corp. — NPI 1639174279, Antioch, CA | NPI Central