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Organization
GUERISOLI DENTAL GROUP INC.
Active
Organization
GUERISOLI DENTAL GROUP INC.
Active
Other names
Ashby Dental in Elmwood
Organization subpart
No
Provider details
NPI number
Authorized official
TRINA BERTELSON (COO)
(775) 722-1724
Entity
Organization
Contact information
Practice address
2507 ASHBY AVE, BERKELEY, CA 94705-2243
(510) 549-0133
Mailing address
2507 ASHBY AVE, BERKELEY, CA 94705-2243
(510) 549-0133
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1528460664
DENTISTRY
CA
01
—
1588704142
DENTISTRY
CA
Enumeration date
02/25/2022
Last updated
08/03/2022
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