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Contact Information

MAXWELL T DISMUKE, DDS
101 WEST COAST RD
REDWAY, CA95560
 Phone: 707-923-2783
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Dentist

122300000X
Indicates primary specialty

NPI Profile & details for MAXWELL T DISMUKE · (Male)

NPI Number 1235098005
Status Active
Credentials DDS (Doctor of Dental Surgery)
Entity Individual
Enumeration date 01/19/2026
Last updated 04/21/2026 - About 1 months ago
Sole proprietor 1 Yes
Identifiers
  • CA License # 112497
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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