in San Jose - General Practice

- NPI 1508916487

is a General Practice in San Jose, California. practices all healthcare services and medical treatments related to General Practice. The NPI Number for is 1508916487. The last update date is .

's current location address is 2596 Bentley Ridge Dr, San Jose, California. You can contact this provider via phone number 4082745420. The mailing address for is 2596 Bentley Ridge Dr, San Jose, California. To know further, please read the information below!

Provider Profile Detail

Provider Name
Address 2596 Bentley Ridge Dr, San Jose, California
Phone Number 4082745420
Fax Number
Sole Proprietor --
Credentials --

NPI Number Detail

NPI Number 1508916487
Provider Enumeration Date
Last Updated Date

Provider Mailing Address Detail

Address 2596 Bentley Ridge Dr
City San Jose
State California (CA)
Post Code 951382436
Phone Number 4082745420
Fax Number

Provider's Primary Taxonomy Detail

Speciality General Practice
Taxonomy 1223G0001X
Licence No 43052
Definition:
A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.

Provider's Other Legacy Identifiers

Identifier Identifier Type Identifier State Identifier Issuer
G91465 CA DENTICAL

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