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General NPI Number Information
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NPI Number | 1598863995
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Entity Type | Individual
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Provider Name | MARISSA TALAVERA SERNA-ARAGOZA DDS
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Gender | Female
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Dates
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Enumeration Date | 09/20/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 3071 STANFORD RANCH ROAD SUITE C3
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City | ROCKLIN
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State | CA
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Zip | 95765
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Country | US
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Telephone | 916-435-2864
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Fax | 916-435-5981
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Provider Business Mailing Address
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Address Line | 3071 STANFORD RANCH ROAD SUITE C3
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City | ROCKLIN
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State | CA
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Zip | 95765
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Country | US
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Telephone | 916-435-2864
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Fax | 916-435-5981
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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 | 47172
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License Number State | CA
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