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Organization
WESTERN DENTAL
Active
Organization
WESTERN DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PIYUSH SISODIA (DDS)
(205) 585-6024
Entity
Organization
Contact information
Practice address
1407 W MARCH LN, STOCKTON, CA 95207-6111
(209) 473-4000
Mailing address
626 ADORA CIR, ROSEVILLE, CA 95678-4404
(205) 585-6024
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
63988
CA
Other
Enumeration date
08/28/2014
Last updated
08/28/2014
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