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3873 Stockdale Hwy Bakersfield CA 93309-2189 | |
| (805) 377-2222 | |
| (805) 377-2222 |
| Full Name | |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 3873 Stockdale Hwy, Bakersfield, California |
| Authorized Official Name and Position | Tisa Siadatie (MANAGING DENTIST) |
| Authorized Official Contact | 6614127747 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
3873 Stockdale Hwy Bakersfield CA 93309-2189 Ph: (661) 412-7747 | 3873 Stockdale Hwy Bakersfield CA 93309-2189 Ph: (805) 377-2222 |
| NPI Number | 1568981017 |
|---|---|
| Provider Enumeration Date | 09/15/2017 |
| Last Update Date | 02/15/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568981017 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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