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General NPI Number Information
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NPI Number | 1013110352
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Entity Type | Organization
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Legal Business Name | JEFFREY W. FRUIN DDS, INC
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Dates
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Enumeration Date | 06/06/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 3257 CAINO DE LOS COCHES 306
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City | SANTA BARBARA
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State | CA
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Zip | 92009
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Country | US
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Telephone | 760-634-8100
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Fax | 760-634-8130
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Provider Business Mailing Address
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Address Line | 3257 CAINO DE LOS COCHES 306
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City | SANTA BARBARA
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State | CA
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Zip | 92009
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Country | US
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Telephone | 760-634-8100
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Fax | 760-634-8130
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Authorized Official
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Title or Position | OWNER
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Name | JEFFREY W FRUIN
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Credential |
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Telephone | 760-634-8100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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