Organization
ELIZABETH SOTOMIL DDS, INC
Active
Other names
Smile Harvest Dental
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ELIZABETH MANZO SOTOMIL DDS (OWNER)
(209) 526-1190
Entity
Organization
Contact information
Practice address
3609 COFFEE RD STE 3, MODESTO, CA 95355-1100
(209) 526-1190
(209) 526-3245
Mailing address
3609 COFFEE RD STE 3, MODESTO, CA 95355-1100
(209) 526-1190
(209) 526-3245
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1154629566
—
CA
Enumeration date
03/27/2019
Last updated
08/21/2019
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