Organization
WEIDEMAN PROFESSIONAL DENTAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CYNTHIA L. WEIDEMAN D.D.S. (OWNER DENTIST)
(916) 962-0577
Entity
Organization
Contact information
Practice address
7916 PEBBLE BEACH DR, SUITE 101, CITRUS HEIGHTS, CA 95610-7790
(916) 962-0577
Mailing address
7916 PEBBLE BEACH DR, SUITE 101, CITRUS HEIGHTS, CA 95610-7790
(916) 962-0577
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
37753
CA
Other
Enumeration date
08/13/2006
Last updated
08/22/2020
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