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General NPI Number Information
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NPI Number | 1184118820
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Entity Type | Individual
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Provider Name | BIANCA CECELIA MACCHIARELLA D.D.S.
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Gender | Female
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Dates
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Enumeration Date | 06/17/2018
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Last Update Date | 06/17/2018
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Provider Practice Location Address
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Address Line | 3635 N FREEWAY BLVD STE 110
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City | SACRAMENTO
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State | CA
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Zip | 95834-2926
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Country | US
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Telephone | 916-285-6691
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Fax |
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Provider Business Mailing Address
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Address Line | 2462 MULLER PL
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City | WOODLAND
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State | CA
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Zip | 95776-5463
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Country | US
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Telephone | 901-569-0713
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 102539
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License Number State | CA
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