Individual
MARTI ANN SIDOLI-TANNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RDH, RDHAP
Contact information
Practice address
6806 W ALLUVIAL AVE, FRESNO, CA 93722-3596
(559) 304-4080
(559) 275-3603
Mailing address
6806 W ALLUVIAL AVE, FRESNO, CA 93722-3596
(559) 275-3603
(559) 275-3603
Taxonomy
Speciality
Code
Description
License number
State
125K00000X
Advanced Practice Dental Therapist
Primary
HAP847
CA
Other
Enumeration date
08/25/2021
Last updated
08/25/2021
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