Organization
KALIKA-IVERSON CORP.
Active
Other names
Image Orthodontics
Organization subpart
No
Provider details
NPI number
Authorized official
LEANI N. MARTINEZ (INS. COORDINATOR)
(916) 783-5239
Entity
Organization
Contact information
Practice address
101 RALEY BLVD, CHICO, CA 95928-8352
(530) 671-2940
Mailing address
101 RALEY BLVD, CHICO, CA 95928-8352
(530) 671-2940
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
37283
—
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
33473
CA
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
45886
CA
Other
Enumeration date
12/03/2012
Last updated
12/20/2013
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