John Ewing Kiesselbach
Dentist Oral and Maxillofacial Surgeon
6000 Fairway Drive Suite 10
Rocklin
, California 95677
John Ewing Kiesselbach
Dentist Oral and Maxillofacial Surgeon
6000 Fairway Drive Suite 10
Rocklin
, California 95677
(916) 632-5814
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About
Features
Specialties
- Dentist
- Oral and Maxillofacial Surgeon
Languages spoken
- English
Location
First Address
- John Ewing Kiesselbach
- 6000 Fairway Drive Suite 10
- Rocklin, CA
- Zip : 95677
- Fax : (916) 632-5814
- Phone : (916) 632-5809
Second Address
- John Ewing Kiesselbach
- 6000 Fairway Drive Suite 10
- Rocklin, CA
- Zip : 95677
- Fax : (916) 632-5814
- Phone : (916) 632-5809
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 122300000X | Dentist | CA24466 | CA |
| N | 1223S0112X | Oral and Maxillofacial Surgeon | CA24466 | CA |
National Provider Identifier
| NPI | 1093903312 |
|---|---|
| Provider Name | John Ewing Kiesselbach |
| First Address | Rocklin, CA 95677 |
| Second Address | Rocklin, CA 95677 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 11/10/2007 |
| Last Update Date | 11/10/2007 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.