Individual
DENISE DILTS-WALDROP
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4626 SHASTA DAM BLVD, SHASTA LAKE, CA 96019-9414
(530) 275-0866
(530) 275-8596
Mailing address
4626 SHASTA DAM BLVD, SHASTA LAKE, CA 96019-9414
(530) 275-0866
(530) 275-8596
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
SL5482
CA
Other
Enumeration date
07/06/2017
Last updated
07/21/2022
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