Healthcare Provider Details

I. General information

NPI: 1720277841
Provider Name (Legal Business Name): MAS'OOD CAJEE DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/15/2007
Last Update Date: 08/29/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

150 W YOSEMITE AVE
MANTECA CA
95336-5602
US

IV. Provider business mailing address

150 W YOSEMITE AVE
MANTECA CA
95336-5602
US

V. Phone/Fax

Practice location:
  • Phone: 209-825-6000
  • Fax:
Mailing address:
  • Phone: 209-825-6000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number48236
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: