Provider Demographics
NPI:1902063985
Name:CLINCIU, ADRIAN TEODOR (DDS)
Entity Type:Individual
Prefix:
First Name:ADRIAN
Middle Name:TEODOR
Last Name:CLINCIU
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7801 LAZY TRAIL CT
Mailing Address - Street 2:
Mailing Address - City:ORANGEVALE
Mailing Address - State:CA
Mailing Address - Zip Code:95662-2123
Mailing Address - Country:US
Mailing Address - Phone:916-662-6295
Mailing Address - Fax:
Practice Address - Street 1:825 E BIDWELL ST STE 400
Practice Address - Street 2:
Practice Address - City:FOLSOM
Practice Address - State:CA
Practice Address - Zip Code:95630-3349
Practice Address - Country:US
Practice Address - Phone:916-984-4591
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-05-19
Last Update Date:2008-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA546531223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice