Provider Demographics
NPI:1922352665
Name:AMMSSO, DALIA A (DDS)
Entity Type:Individual
Prefix:DR
First Name:DALIA
Middle Name:A
Last Name:AMMSSO
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 COLMAR CT
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:94506-1938
Mailing Address - Country:US
Mailing Address - Phone:925-964-5777
Mailing Address - Fax:
Practice Address - Street 1:6660 LONE TREE WAY
Practice Address - Street 2:SUITE 7
Practice Address - City:BRENTWOOD
Practice Address - State:CA
Practice Address - Zip Code:94513-5370
Practice Address - Country:US
Practice Address - Phone:925-513-8363
Practice Address - Fax:925-513-7508
Is Sole Proprietor?:No
Enumeration Date:2012-11-02
Last Update Date:2014-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA619621223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice