Organization
PARTNERSHIP FOR THE CHILDREN OF SAN LUIS OBISPO CO
Active
Other names
Tolosa Childrens Dental Center
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JON E. HOLLISTER D.D.S (PRESIDENT)
(805) 543-6963
Entity
Organization
Contact information
Practice address
717 WALNUT DRIVE, PASO ROBLES, CA 93446-2315
(805) 238-5334
(805) 238-6470
Mailing address
717 WALNUT DRIVE, PASO ROBLES, CA 93446-2315
(805) 238-5334
(805) 238-6470
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
—
—
1223P0221X
Pediatric Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4192751G
—
CA
Enumeration date
09/13/2006
Last updated
02/27/2014
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