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General NPI Number Information
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NPI Number | 1992834378
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Entity Type | Organization
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Legal Business Name | ASTERITA A. MACHADO, DDS, INC.
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Dates
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Enumeration Date | 03/03/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1331 GUERNEVILLE RD STE G
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City | SANTA ROSA
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State | CA
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Zip | 95403-4162
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Country | US
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Telephone | 707-526-6800
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Fax |
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Provider Business Mailing Address
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Address Line | 3203 FITZPATRICK CT
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City | SANTA ROSA
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State | CA
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Zip | 95404-1800
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Country | US
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Telephone | 707-573-1902
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Fax |
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Authorized Official
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Title or Position | PROPRIETOR
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Name | ASTERITA MACHADO
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Credential | DDS
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Telephone | 707-526-6800
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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 | 49369
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License Number State | CA
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