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Organization
ELIZABETH SOTOMIL DDS, INC
Active
Organization
ELIZABETH SOTOMIL DDS, INC
Active
Other names
Smile Harvest Dental
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ELIZABETH MANZO SOTOMIL DDS (OWNER)
(209) 526-1190
Entity
Organization
Contact information
Practice address
3609 COFFEE RD STE 3, MODESTO, CA 95355-1100
(209) 526-1190
(209) 526-3245
Mailing address
3609 COFFEE RD STE 3, MODESTO, CA 95355-1100
(209) 526-1190
(209) 526-3245
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1154629566
—
CA
Enumeration date
03/27/2019
Last updated
08/21/2019
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