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General NPI Number Information
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NPI Number | 1053533869
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Entity Type | Individual
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Provider Name | THELMA CARDONA DAWANA DMD
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Gender | Female
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Dates
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Enumeration Date | 05/02/2007
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Last Update Date | 03/03/2008
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Provider Practice Location Address
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Address Line | 995 MONTAGUE EXPY STE 112
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City | MILPITAS
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State | CA
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Zip | 95035-6827
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Country | US
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Telephone | 408-719-1005
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Fax | 408-907-9182
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Provider Business Mailing Address
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Address Line | 995 MONTAGUE EXPY STE 112
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City | MILPITAS
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State | CA
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Zip | 95035-6827
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Country | US
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Telephone | 408-719-1005
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Fax | 408-907-9182
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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 | 54746
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License Number State | CA
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