Individual
ALYSSA GIANELLA COULTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1528 S EL CAMINO REAL STE 408, SAN MATEO, CA 94402-3067
(650) 212-3500
(650) 212-3505
Mailing address
352 PINE ST, MILLBRAE, CA 94030-2019
(650) 274-3328
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
109406
CA
Other
Enumeration date
04/10/2022
Last updated
11/21/2024
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