Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223X0400X | Orthodontists | 22179 | CA |
NPI | 1013173418 |
---|---|
Provider Name | Dr. Jon Ester Sammann |
First Address | Lafayette, CA 94549-5046 |
Second Address | Lafayette, CA 94549-5046 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/08/2008 |
Last Update Date | 05/08/2008 |