Provider Demographics
NPI:1114397791
Name:SORIA, ANTONIETTA TABIJE (DMD)
Entity Type:Individual
Prefix:DR
First Name:ANTONIETTA
Middle Name:TABIJE
Last Name:SORIA
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1004 N. DAVIS RD.
Mailing Address - Street 2:
Mailing Address - City:SALINAS
Mailing Address - State:CA
Mailing Address - Zip Code:93907
Mailing Address - Country:US
Mailing Address - Phone:831-753-7606
Mailing Address - Fax:831-753-7607
Practice Address - Street 1:1004 N. DAVIS RD.
Practice Address - Street 2:
Practice Address - City:SALINAS
Practice Address - State:CA
Practice Address - Zip Code:93907
Practice Address - Country:US
Practice Address - Phone:831-753-7606
Practice Address - Fax:831-753-7607
Is Sole Proprietor?:No
Enumeration Date:2015-09-25
Last Update Date:2015-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA52935122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist