Healthcare Provider Details

I. General information

NPI: 1578753885
Provider Name (Legal Business Name): CATURAY DENTAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/01/2007
Last Update Date: 10/22/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1301 BROADWAY STE 7
MILLBRAE CA
94030-1336
US

IV. Provider business mailing address

1555 WEBSTER ST SUITE B
FAIRFIELD CA
94533-4999
US

V. Phone/Fax

Practice location:
  • Phone: 650-589-3667
  • Fax:
Mailing address:
  • Phone: 707-435-1906
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number39609
License Number StateCA

VIII. Authorized Official

Name: DR. PEDRO CATURAY
Title or Position: OWNER
Credential: DDS
Phone: 650-589-3667