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General NPI Number Information
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NPI Number | 1811412794
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Entity Type | Organization
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Legal Business Name | CRISTIAN A SIERRA, D.M.D., INC.
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Dates
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Enumeration Date | 08/11/2017
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Last Update Date | 12/12/2019
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Provider Practice Location Address
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Address Line | 5960 WEST MALL STE A
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City | ATASCADERO
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State | CA
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Zip | 93422-4232
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Country | US
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Telephone | 909-528-1252
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Fax | 805-466-6831
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Provider Business Mailing Address
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Address Line | PO BOX 1319
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City | ARROYO GRANDE
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State | CA
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Zip | 93421-1319
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Country | US
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Telephone | 19095281252
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. CRISTIAN AMADO SIERRA
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Credential | DMD
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Telephone | 909-528-1252
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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