Derry L. Hildebrand, D.D.S. Valid NPI
Individual provider · Dentist · Portola, CA
- NPI
- 1114175817
- Type
- Individual (Type 1)
- Primary specialty
- Dentist
- Specialty group
- Dental Providers
- Taxonomy code
- 122300000X
- License number
- 19626 (CA)
- Sex
- Male
- Sole proprietor
- Yes
- Enumerated
- 2008-09-05
- Last updated
- 2009-10-05
Practice location
296 W Sierra Ave., Ste 1
Portola, CA 96122-8627
(530) 832-0200