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Organization
MICHAEL C DITOLLA DDS PROFESSIONAL DENTAL CORPORATION
Active
Organization
MICHAEL C DITOLLA DDS PROFESSIONAL DENTAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL C DITOLLA DDS (PRESIDENT)
(714) 420-4053
Entity
Organization
Contact information
Practice address
630 S FAIRMONT AVE STE D, LODI, CA 95240-3803
(714) 420-4053
Mailing address
630 S FAIRMONT AVE STE D, LODI, CA 95240-3803
(209) 333-3388
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
06/01/2021
Last updated
04/02/2024
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