MEDICARE: CATURAY DENTAL CORPORATION

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	39609	CA

General Provider Information

NPI Number	:	1578753885
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CATURAY DENTAL CORPORATION

Provider Business Mailing Address
First Line	:	1555 WEBSTER ST
Second Line	:	SUITE B
City	:	FAIRFIELD
State	:	CA
Zip	:	94533-4999
Country	:	US
Telephone Number	:	707-435-1906
Fax Number	:

Provider Business Practice Location Address
First Line	:	1301 BROADWAY STE 7
Second Line	:
City	:	MILLBRAE
State	:	CA
Zip	:	94030-1336
Country	:	US
Telephone Number	:	650-589-3667
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. PEDRO CATURAY
Credential	:	DDS
Telephone Number	:	650-589-3667

Provider Enumeration Date	:	08/01/2007
Last Update Date	:	10/22/2008

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Directions to “CATURAY DENTAL CORPORATION ” Practice Location

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