Individual
DERRY L. HILDEBRAND JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
296 W SIERRA AVE., STE 1, PORTOLA, CA 96122-8627
(530) 832-0200
(530) 832-0900
Mailing address
296 W SIERRA AVENUE, STE 1, PORTOLA, CA 96122-8627
(530) 832-0200
(530) 832-0900
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
19626
CA
Other
Enumeration date
09/05/2008
Last updated
10/05/2009
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