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General NPI Number Information
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NPI Number | 1154727451
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Entity Type | Organization
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Legal Business Name | TALA V. GREDINBERG, D.D.S., INC.
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Dates
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Enumeration Date | 11/13/2014
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Last Update Date | 04/24/2015
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Provider Practice Location Address
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Address Line | 323 N SANBORN RD SUIT #F
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City | SALINAS
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State | CA
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Zip | 93905-2247
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Country | US
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Telephone | 831-422-9011
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Fax |
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Provider Business Mailing Address
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Address Line | 323 N SANBORN RD SUIT #F
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City | SALINAS
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State | CA
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Zip | 93905-2247
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Country | US
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Telephone | 831-422-9011
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | TALA V GREDINBERG
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Credential | DDS
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Telephone | 408-422-9011
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 56303
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License Number State | CA
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