David William Wistrom DDS

NPI 1083632368 - Dentist - 1223G0001X

NPI Details
NPI 1083632368
Gender Male
Enumeration Date 07/17/2006
Last Updated 04/08/2014
Entity Type Individual
Active Over 10 years ago
Practice Location
1830 COMMERCIAL WAY
SANTA CRUZ CA, 95065-1819, US
Phone (831) 464-5409
Fax (831) 464-5415
Business Location
1830 COMMERCIAL WAY
SANTA CRUZ CA, 95065-1819, US
Phone (831) 464-5409
Fax (831) 464-5415
Toxanomy
Taxonomy Code 1223G0001X
License State California
License Number 42785
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According to our database, Dr. David William Wistrom DDS NPI is 1083632368, taxonomy code is 1223G0001X and license number is 42785, license state is located at California. David William Wistrom DDS physically located at 1830 Commercial Way, Santa Cruz CA, 95065-1819. NPI Number David William Wistrom DDS has the Individual type.

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1083632368 NPI number is provided on an as is basis without warranty of any kind. 1083632368 is maintained by the National Plan & Provider Enumeration System. The contents of David William Wistrom DDS are for informational purposes only.