Provider Demographics
NPI:1861543589
Name:CALAVERAS COUNTY OFFICE OF EDUCATION
Entity type:Organization
Organization Name:CALAVERAS COUNTY OFFICE OF EDUCATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:SUPERVISING DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:THOMAS
Authorized Official - Last Name:MARSHALL
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:209-795-9942
Mailing Address - Street 1:PO BOX 760
Mailing Address - Street 2:
Mailing Address - City:ANGELS CAMP
Mailing Address - State:CA
Mailing Address - Zip Code:95221-0760
Mailing Address - Country:US
Mailing Address - Phone:209-795-9942
Mailing Address - Fax:209-795-9943
Practice Address - Street 1:185 S. MAIN ST
Practice Address - Street 2:
Practice Address - City:ANGELS CAMP
Practice Address - State:CA
Practice Address - Zip Code:95221-0760
Practice Address - Country:US
Practice Address - Phone:209-736-6001
Practice Address - Fax:209-736-2138
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-16
Last Update Date:2008-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)