Individual
A. KEYLA SPRINGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.D.S.
Contact information
Practice address
143 NIBLICK RD, PASO ROBLES, CA 93446-4844
(805) 226-8126
Mailing address
143 NIBLICK RD, PASO ROBLES, CA 93446-4844
(805) 226-8126
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
40523
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
342069
UNITED CONCORDIA PROV ID
CA
01
—
711004208
FEDERAL TAX ID
CA
Enumeration date
01/09/2007
Last updated
07/08/2007
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