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Organization
INTERDENTAL CARE
Active
Organization
INTERDENTAL CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARIANO WENDELL GUERRA DDS (DENTIST)
(916) 787-0631
Entity
Organization
Contact information
Practice address
106 N SUNRISE AVE, SUITE B-10, ROSEVILLE, CA 95661-2906
(916) 878-0631
Mailing address
106 N SUNRISE AVE STE B10, ROSEVILLE, CA 95661-2915
(916) 787-0631
(916) 787-3277
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
47082
CA
Other
Enumeration date
02/22/2007
Last updated
08/22/2020
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