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General NPI Number Information
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NPI Number | 1023158722
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Entity Type | Individual
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Provider Name | EDELYN MANUEL SANTOS DDS
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Gender | Female
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Dates
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Enumeration Date | 02/08/2007
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Last Update Date | 04/19/2012
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Provider Practice Location Address
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Address Line | 33341 ALVARADO NILES RD
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City | UNION CITY
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State | CA
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Zip | 94587-3195
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Country | US
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Telephone | 510-471-9300
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Fax | 510-471-9300
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Provider Business Mailing Address
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Address Line | 4287 GEORGE AVE #2
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City | SAN MATEO
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State | CA
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Zip | 94403-4698
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Country | US
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Telephone | 650-867-2128
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 46628
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License Number State | CA
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