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General NPI Number Information
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NPI Number | 1750552410
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Entity Type | Organization
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Legal Business Name | RICHARD PORTALUPI DDS, MSD, AND R. SCOTT ANDERSON, DMD, A DENTAL CORP
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Dates
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Enumeration Date | 03/20/2008
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Last Update Date | 03/20/2008
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Provider Practice Location Address
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Address Line | 2070 PEABODY RD STE 700
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City | VACAVILLE
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State | CA
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Zip | 95687-6697
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Country | US
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Telephone | 707-452-1111
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Fax | 707-452-0277
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Provider Business Mailing Address
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Address Line | 2070 PEABODY RD STE 700
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City | VACAVILLE
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State | CA
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Zip | 95687-6697
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Country | US
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Telephone | 707-452-1111
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Fax | 707-452-0277
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Authorized Official
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Title or Position | ORTHODONTIST
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Name | DR. R. SCOTT ANDERSON
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Credential | DMD
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Telephone | 707-452-1111
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number |
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License Number State | CA
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