Organization
BYRON P SANSOM A DENTAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BYRON PAUL SANSOM D.D.S. (OWNER/DENTIST)
(760) 934-3730
Entity
Organization
Contact information
Practice address
452 OLD MAMMOTH RD., SUITE L, MAMMOTH LAKES, CA 93546
(760) 934-3730
(760) 934-3732
Mailing address
PO BOX 100, PMB #389, MAMMOTH LAKES, CA 93546-0100
(760) 934-3730
(760) 934-3732
Taxonomy
Speciality
Code
Description
License number
State
282NR1301X
Rural Acute Care Hospital
Primary
33366
CA
Other
Enumeration date
08/14/2006
Last updated
11/05/2013
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