Provider Demographics
NPI:1063621167
Name:GLOOR, VANESSA (DDS, RDH)
Entity type:Individual
Prefix:
First Name:VANESSA
Middle Name:
Last Name:GLOOR
Suffix:
Gender:F
Credentials:DDS, RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1844 SAN MIGUEL DR
Mailing Address - Street 2:SUITE #106
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94596-4962
Mailing Address - Country:US
Mailing Address - Phone:925-939-3997
Mailing Address - Fax:925-939-3687
Practice Address - Street 1:1844 SAN MIGUEL DR
Practice Address - Street 2:SUITE #106
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94596-4962
Practice Address - Country:US
Practice Address - Phone:925-939-3997
Practice Address - Fax:925-939-3687
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice