Organization
B. MADZAREVIC, D.D.S., INC.
Active
Parent organization
B. MADZAREVIC, DDS, INC.
Other names
Creekside Dental
Organization subpart
Yes
Provider details
NPI number
Legal business name
B. MADZAREVIC, DDS, INC.
Authorized official
DR. BRANISLAV MADZAREVIC DDS (PRESIDENT)
(805) 462-8710
Entity
Organization
Contact information
Practice address
8840 MORRO RD, ATASCADERO, CA 93422-3953
(805) 462-8710
Mailing address
8840 MORRO RD, ATASCADERO, CA 93422-3953
(805) 462-8710
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
CA31057
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1639340425
PERSONAL/INDIVIDUAL
CA
Enumeration date
11/08/2014
Last updated
11/08/2014
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