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466 E Calaveras Blvd Suite B Milpitas CA 95035-5453 | |
| (408) 263-6660 | |
| (408) 263-8409 |
| Full Name | |
|---|---|
| Speciality | Dentist - Endodontics |
| Location | 466 E Calaveras Blvd, Milpitas, California |
| Authorized Official Name and Position | Micah M. Oller (OWNER) |
| Authorized Official Contact | 4082636660 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
466 E Calaveras Blvd Suite B Milpitas CA 95035-5453 Ph: (408) 263-6660 | 466 E Calaveras Blvd Suite B Milpitas CA 95035-5453 Ph: (408) 263-6660 |
| NPI Number | 1295016608 |
|---|---|
| Provider Enumeration Date | 08/30/2011 |
| Last Update Date | 08/30/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295016608 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223E0200X | Dentist - Endodontics | 45163 (California) | Primary |
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