Individual
DR. MARC CALLEN DEBERARDINIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D., M.S.
Contact information
Practice address
1476 PROFESSIONAL DR, SUITE 506, PETALUMA, CA 94954-1500
(707) 762-0211
(707) 762-5149
Mailing address
2050 DIVISADERO ST, #1, SAN FRANCISCO, CA 94115-2113
(415) 706-8662
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
46375
CA
Other
Enumeration date
03/02/2007
Last updated
07/08/2007
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