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General NPI Number Information
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NPI Number | 1093353401
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Entity Type | Organization
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Legal Business Name | MARINA MILSTEIN DDS INC
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Dates
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Enumeration Date | 12/16/2019
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Last Update Date | 02/24/2020
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Provider Practice Location Address
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Address Line | 7095 DOUGLAS BLVD STE A
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City | GRANITE BAY
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State | CA
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Zip | 95746-6299
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Country | US
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Telephone | 916-677-1216
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Fax |
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Provider Business Mailing Address
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Address Line | 7095 DOUGLAS BLVD STE A
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City | GRANITE BAY
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State | CA
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Zip | 95746-6299
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Country | US
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Telephone | 916-677-1216
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MARINA V MILSTEIN
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Credential | DDS
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Telephone | 916-677-1216
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number |
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License Number State |
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