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General NPI Number Information
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NPI Number | 1043615933
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Entity Type | Organization
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Legal Business Name | MARLEEN M. MASUOKA, DDS
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Dates
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Enumeration Date | 11/04/2014
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Last Update Date | 11/04/2014
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Provider Practice Location Address
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Address Line | 8080 MADISON AVENUE SUITE 202
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City | FAIR OAKS
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State | CA
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Zip | 95628-3736
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Country | US
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Telephone | 916-966-9900
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Fax | 888-647-2117
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Provider Business Mailing Address
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Address Line | 8080 MADISON AVENUE SUITE 202
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City | FAIR OAKS
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State | CA
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Zip | 95628-3736
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Country | US
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Telephone | 916-966-9900
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Fax | 888-647-2117
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Authorized Official
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Title or Position | BUSINESS OWNER
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Name | MARLEEN M. MASUOKA
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Credential | DDS
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Telephone | 916-966-9900
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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 | 41279
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License Number State | CA
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