Individual
MICHAEL JOHN SCIANAMBLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1526 5TH AVE, SAN RAFAEL, CA 94901-1852
(415) 457-3002
(415) 457-0591
Mailing address
1526 5TH AVE, SAN RAFAEL, CA 94901-1852
(415) 457-3002
(415) 457-0591
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
27065
CA
Other
Enumeration date
12/29/2006
Last updated
07/08/2007
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