Provider Demographics
NPI:1811412794
Name:CRISTIAN A SIERRA, D.M.D., INC.
Entity Type:Organization
Organization Name:CRISTIAN A SIERRA, D.M.D., INC.
Other - Org Name:DRS. GUITTARD & SIERRA FAMILY DENTISTRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CRISTIAN
Authorized Official - Middle Name:AMADO
Authorized Official - Last Name:SIERRA
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:909-528-1252
Mailing Address - Street 1:PO BOX 1319
Mailing Address - Street 2:
Mailing Address - City:ARROYO GRANDE
Mailing Address - State:CA
Mailing Address - Zip Code:93421-1319
Mailing Address - Country:US
Mailing Address - Phone:1909-528-1252
Mailing Address - Fax:
Practice Address - Street 1:5960 WEST MALL STE A
Practice Address - Street 2:
Practice Address - City:ATASCADERO
Practice Address - State:CA
Practice Address - Zip Code:93422-4232
Practice Address - Country:US
Practice Address - Phone:909-528-1252
Practice Address - Fax:805-466-6831
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-11
Last Update Date:2019-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental