Provider Demographics
NPI:1790904241
Name:SORIA, DALE ADRIAN (DDS)
Entity Type:Individual
Prefix:
First Name:DALE
Middle Name:ADRIAN
Last Name:SORIA
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 486
Mailing Address - Street 2:
Mailing Address - City:YOSEMITE
Mailing Address - State:CA
Mailing Address - Zip Code:95389
Mailing Address - Country:US
Mailing Address - Phone:209-372-4200
Mailing Address - Fax:
Practice Address - Street 1:9000 AHWAHNEE DRIVE
Practice Address - Street 2:
Practice Address - City:YOSEMITE
Practice Address - State:CA
Practice Address - Zip Code:95389
Practice Address - Country:US
Practice Address - Phone:209-372-4200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-24
Last Update Date:2008-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA26130122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist