Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0300X | Periodontist | 36662 | CA |
NPI | 1063638799 |
---|---|
Provider Name | Dr. Michele Hatt Vignaroli |
First Address | Danville, CA 94506-2140 |
Second Address | Livermore, CA 94550-4143 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/04/2007 |
Last Update Date | 08/07/2007 |