Organization
ALEXANDER ANTIPOV INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TIA MARIE BYCROFT (MANAGER)
(916) 783-2110
Entity
Organization
Contact information
Practice address
927 RESERVE DR, SUITE A, ROSEVILLE, CA 95678
(916) 783-2110
Mailing address
927 RESERVE DR, SUITE A, ROSEVILLE, CA 95678
(916) 783-2110
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
50724
CA
Other
Enumeration date
03/09/2010
Last updated
03/09/2010
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