Individual
DEANNA MARIE MADDOX BROTHERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
937 SAN FRANCISCO AVE, SOUTH LAKE TAHOE, CA 96150
(530) 544-2441
(530) 544-2179
Mailing address
PO BOX 8979, 937 SAN FRANCISCO AVE, SOUTH LAKE TAHOE, CA 96158
(530) 544-2441
(530) 544-2179
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
036732
CA
122300000X
Dentist
4773T
NV
Other
Enumeration date
01/22/2007
Last updated
07/08/2007
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