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General NPI Number Information
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NPI Number | 1861603664
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Entity Type | Organization
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Legal Business Name | RODERIC B. PANZER
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Dates
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Enumeration Date | 05/24/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1980 ALAMO DR STE 2
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City | VACAVILLE
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State | CA
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Zip | 95687-6100
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Country | US
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Telephone | 707-449-3777
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Fax | 707-449-0754
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Provider Business Mailing Address
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Address Line | 1980 ALAMO DR STE 2
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City | VACAVILLE
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State | CA
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Zip | 95687-6100
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Country | US
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Telephone | 707-449-3777
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Fax | 707-449-0754
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Authorized Official
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Title or Position | DENTIST
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Name | DR. RODERIC B PANZER
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Credential | D.D.S.
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Telephone | 707-449-3777
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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 | 36691
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 22417
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License Number State | CA
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