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NPI Code Detail

MEDICARE: DR. LISA SARASQUETA D.D.S.

MEDICARE:  DR. LISA  SARASQUETA  D.D.S.
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
11223G0001XGeneral Practice Dentistry35165CA

General Provider Information

NPI Number : 1871613638
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. LISA SARASQUETA D.D.S.
Provider Business Mailing Address
First Line : PO BOX 596
Second Line :
City : PATTERSON
State : CA
Zip : 95363-0596
Country : US
Telephone Number : 209-892-6702
Fax Number : 209-892-2220
Provider Business Practice Location Address
First Line : 335 W LAS PALMAS AVE
Second Line :
City : PATTERSON
State : CA
Zip : 95363-2519
Country : US
Telephone Number : 209-892-6702
Fax Number : 209-892-2220
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/29/2007
Last Update Date : 07/08/2007

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Directions to “ DR. LISA SARASQUETA D.D.S.” Practice Location

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