Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0700X | Prosthodontist | 52371 | CA |
NPI | 1134336043 |
---|---|
Provider Name | Dr. Noah Chris Dehlinger |
First Address | San Anselmo, CA 94960-2539 |
Second Address | San Anselmo, CA 94960-2359 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/05/2007 |
Last Update Date | 08/07/2007 |