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Organization
PORTIA MARISTELA ESCOBAR, DMD, PDC
Active
Organization
PORTIA MARISTELA ESCOBAR, DMD, PDC
Active
Other names
Portia Maristela Escobar, Professional Dental Corporation
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PORTIA ESCOBAR DMD (PRESIDENT)
(707) 557-6680
Entity
Organization
Contact information
Practice address
3772 SONOMA BLVD, VALLEJO, CA 94589-2202
(707) 557-6680
(707) 554-6688
Mailing address
3772 SONOMA BLVD, VALLEJO, CA 94589-2202
(707) 557-6680
(707) 554-6688
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
45854
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
B45854-01
HEALTHY FAMILIES
CA
Enumeration date
03/20/2007
Last updated
04/30/2012
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