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Organization
MARIA LOURDES DIMATERA DMD
Active
Organization
MARIA LOURDES DIMATERA DMD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARIA LOURDES BRIZ DIMATERA DMD (OWNER)
(559) 876-1777
Entity
Organization
Contact information
Practice address
801 N ST, SANGER, CA 93657-3115
(559) 876-1777
(559) 876-2763
Mailing address
801 N ST, SANGER, CA 93657-3115
(559) 876-1777
(559) 876-2763
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
44862
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
44862
BILLING PROVIDER NUMBER
CA
01
—
G9408101
DENTICAL BILLING NUMBER
CA
Enumeration date
07/02/2007
Last updated
09/08/2008
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