Individual
DERRICK S TANIHARA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1568 CREEKSIDE DR, STE 201, FOLSOM, CA 95630
(916) 482-4853
Mailing address
2500 FAIR OAKS BLVD, #4, SACRAMENTO, CA 95825
(916) 482-4853
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
46222
CA
Other
Enumeration date
12/27/2006
Last updated
07/08/2007
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