OrganizationShasta College Dental Hygiene ProgramDentistDental ProvidersPractice Address2701 Eureka Way, Suite 2a, Redding, CA 96001-0228(530) 245-7332PECOS EnrollmentBased on the most recent information from CMS, provider Shasta College Dental Hygiene Program does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 12:57 PM.Profile DetailsProvider ID1992927024Provider TypeOrganizationFull NameShasta College Dental Hygiene ProgramSubpartNoEnumeration Date5/2/2007Last Updated8/22/2020Contact InformationPractice LocationPractice Address2701 Eureka Way, Suite 2a, Redding, CA 96001-0228Phone(530) 245-7332Fax(530) 245-7333Mailing LocationMailing Address2701 Eureka Way, Suite 2a, Redding, CA 96001-0228Phone(530) 245-7332Fax(530) 245-7333Authorized OfficialNameRichards, Jennifer (Receptionist)Phone(530) 245-7332Provider TaxonomiesCodeDescriptionLicenseCode122300000XPrimaryDescriptionDentistDental ProvidersLicenseG92107-01CaliforniaProvider IdentifiersIDDescriptionIssuerIDG92107-01DescriptionOtherIssuerPROVIDER NOCalifornia