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General NPI Number Information
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NPI Number | 1124724174
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Entity Type | Organization
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Legal Business Name | ALVIN SITOMPUL D.D.S, INC.
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Dates
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Enumeration Date | 02/01/2023
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Last Update Date | 02/01/2023
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Provider Practice Location Address
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Address Line | 3820 WIBLE RD STE B
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City | BAKERSFIELD
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State | CA
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Zip | 93309-6714
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Country | US
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Telephone | 805-217-8993
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Fax |
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Provider Business Mailing Address
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Address Line | 11294 TIGER LILY ST
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City | VENTURA
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State | CA
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Zip | 93004-3350
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Country | US
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Telephone | 805-390-7042
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | ALVIN SITOMPUL
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Credential | DDS
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Telephone | 805-390-7042
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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