Provider Demographics
NPI:1386985208
Name:JANICE R WORK DDS /A PROFESSIONAL DENTAL CORPORATION
Entity type:Organization
Organization Name:JANICE R WORK DDS /A PROFESSIONAL DENTAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JANICE
Authorized Official - Middle Name:RENE
Authorized Official - Last Name:WORK
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:916-683-7336
Mailing Address - Street 1:9045 BRUCEVILLE RD STE 180
Mailing Address - Street 2:
Mailing Address - City:ELK GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:95758-5951
Mailing Address - Country:US
Mailing Address - Phone:916-683-7336
Mailing Address - Fax:916-836-7340
Practice Address - Street 1:9045 BRUCEVILLE RD
Practice Address - Street 2:180
Practice Address - City:ELK GROVE
Practice Address - State:CA
Practice Address - Zip Code:95758-5948
Practice Address - Country:US
Practice Address - Phone:916-683-7336
Practice Address - Fax:916-683-7340
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-04
Last Update Date:2013-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty