Organization
SANTA CRUZ CHILDREN'S DENTAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RYAN C WITTWER DDS,MS (OWNER)
(831) 476-5520
Entity
Organization
Contact information
Practice address
1667 DOMINICAN WAY STE 232, SANTA CRUZ, CA 95065-1560
(831) 476-5520
(831) 476-5584
Mailing address
1667 DOMINICAN WAY STE 232, SANTA CRUZ, CA 95065-1560
(831) 476-5520
(831) 476-5584
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
56989
CA
Other
Enumeration date
12/08/2010
Last updated
12/08/2010
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