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Organization

HACIENDA DENTAL, INC

Active
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Organization

HACIENDA DENTAL, INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. WILSON MYERS JR. D.D.S (OWNER/DOCTOR)
(925) 734-0104
Entity
Organization

Contact information

Practice address
5674 STONERIDGE DR, SUITE 111, PLEASANTON, CA 94588-8500
(925) 734-0104
(924) 734-0489
Mailing address
5674 STONERIDGE DR, SUITE 111, PLEASANTON, CA 94588-8500
(925) 734-0104
(924) 734-0489

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
24840
CA

Other

Enumeration date
09/17/2008
Last updated
09/17/2008
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