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NPI Code Detail

MEDICARE: CRISTIAN A SIERRA, D.M.D., INC.

MEDICARE: CRISTIAN A SIERRA, D.M.D., INC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QD0000XDental Clinic/Center

General Provider Information

NPI Number : 1811412794
Entity Type Code : Organization
Provider Name (Legal Business Name) : CRISTIAN A SIERRA, D.M.D., INC.
Provider Business Mailing Address
First Line : PO BOX 1319
Second Line :
City : ARROYO GRANDE
State : CA
Zip : 93421-1319
Country : US
Telephone Number : 19095281252
Fax Number :
Provider Business Practice Location Address
First Line : 5960 WEST MALL STE A
Second Line :
City : ATASCADERO
State : CA
Zip : 93422-4232
Country : US
Telephone Number : 909-528-1252
Fax Number : 805-466-6831
Authorized Official
Title or Position : PRESIDENT
Name : DR. CRISTIAN AMADO SIERRA
Credential : DMD
Telephone Number : 909-528-1252
Provider Enumeration Date : 08/11/2017
Last Update Date : 12/12/2019

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Directions to “CRISTIAN A SIERRA, D.M.D., INC. ” Practice Location

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