Provider Demographics
NPI:1619002748
Name:MARISSA T. SERNA-ARAGOZA,D.D.S.,A.P.C.
Entity Type:Organization
Organization Name:MARISSA T. SERNA-ARAGOZA,D.D.S.,A.P.C.
Other - Org Name:GENTLE CARE FAMILY DENTISTRY AT STANFORD RANCH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHAIRMAN OF THE BOARD
Authorized Official - Prefix:DR
Authorized Official - First Name:MARISSA
Authorized Official - Middle Name:T
Authorized Official - Last Name:SERNA-ARAGOZA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:916-435-2864
Mailing Address - Street 1:3071 STANFORD RANCH RD
Mailing Address - Street 2:SUITE C-3
Mailing Address - City:ROCKLIN
Mailing Address - State:CA
Mailing Address - Zip Code:95765-5564
Mailing Address - Country:US
Mailing Address - Phone:916-435-2864
Mailing Address - Fax:916-435-5981
Practice Address - Street 1:3071 STANFORD RANCH RD
Practice Address - Street 2:SUITE C-3
Practice Address - City:ROCKLIN
Practice Address - State:CA
Practice Address - Zip Code:95765-5564
Practice Address - Country:US
Practice Address - Phone:916-435-2864
Practice Address - Fax:916-435-5981
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA471721223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty