Provider Demographics
NPI:1619744810
Name:MUIR HILLS DENTAL PARTNERSHIP
Entity Type:Organization
Organization Name:MUIR HILLS DENTAL PARTNERSHIP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KRISTAN
Authorized Official - Middle Name:
Authorized Official - Last Name:GHISLETTA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:925-330-7086
Mailing Address - Street 1:710 GRAYSON RD
Mailing Address - Street 2:
Mailing Address - City:PLEASANT HILL
Mailing Address - State:CA
Mailing Address - Zip Code:94523-2687
Mailing Address - Country:US
Mailing Address - Phone:925-330-7086
Mailing Address - Fax:
Practice Address - Street 1:710 GRAYSON RD
Practice Address - Street 2:
Practice Address - City:PLEASANT HILL
Practice Address - State:CA
Practice Address - Zip Code:94523-2687
Practice Address - Country:US
Practice Address - Phone:925-330-7086
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-07
Last Update Date:2023-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty