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General NPI Number Information
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NPI Number | 1336358902
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Entity Type | Individual
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Provider Name | MARIA VICTORIA C. SISON-ROSARIO DDS
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Gender | Female
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Dates
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Enumeration Date | 05/21/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 152 W BASTANCHURY RD
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City | FULLERTON
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State | CA
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Zip | 92835-2502
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Country | US
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Telephone | 714-890-1171
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Fax | 714-870-9330
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Provider Business Mailing Address
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Address Line | 152 W BASTANCHURY RD
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City | FULLERTON
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State | CA
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Zip | 92835-2502
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Country | US
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Telephone | 714-890-1171
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Fax | 714-870-9330
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | 53503
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License Number State | CA
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