Organization
UP VALLEY PEDIATRIC DENTISTRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KIMBERLY GRACE NICHELINI D.M.D. (PARTNER - PEDIATRIC DENTIST)
(707) 968-5144
Entity
Organization
Contact information
Practice address
176 MAIN ST STE A, SAINT HELENA, CA 94574-2108
(707) 968-5144
(707) 302-5298
Mailing address
176 MAIN ST STE A, SAINT HELENA, CA 94574-2108
(707) 968-5144
(707) 302-5298
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1164719753
—
NY
Enumeration date
11/03/2020
Last updated
11/03/2020
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