Organization
SIADATIE A PROF DENTAL CORP
Active
Other names
accessible dental center
Organization subpart
No
Provider details
NPI number
Authorized official
TISA SIADATIE DDS (MANAGING DENTIST)
(661) 412-7747
Entity
Organization
Contact information
Practice address
3873 STOCKDALE HWY, BAKERSFIELD, CA 93309-2189
(805) 377-2222
(805) 377-2222
Mailing address
3873 STOCKDALE HWY, BAKERSFIELD, CA 93309-2189
(661) 412-7747
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
09/15/2017
Last updated
02/15/2021
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