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Organization
LERIAN DENTAL CORPORATION
Active
Organization
LERIAN DENTAL CORPORATION
Active
Other names
Gentle Dental Hillsdale
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. FAITH RAMIENTOS TABUJARA (CREDENTIALING COORDINATOR)
(209) 476-4728
Entity
Organization
Contact information
Practice address
360 HILLSDALE MALL, SAN MATEO, CA 94403-3425
(650) 341-8008
(650) 341-7675
Mailing address
555 W BENJAMIN HOLT DR, BLDG B, STOCKTON, CA 95207-3839
(209) 476-4700
(209) 478-8758
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
13847
CA
Other
Enumeration date
04/20/2006
Last updated
08/22/2020
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