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General NPI Number Information
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NPI Number | 1063560381
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Entity Type | Organization
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Legal Business Name | MA LOURDES ANDRES-JAVIER, DDS INC.
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Dates
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Enumeration Date | 01/05/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1415 BRUNDAGE LN
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City | BAKERSFIELD
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State | CA
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Zip | 93304-3114
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Country | US
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Telephone | 661-323-0076
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Fax | 661-323-0277
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Provider Business Mailing Address
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Address Line | 1415 BRUNDAGE LN
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City | BAKERSFIELD
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State | CA
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Zip | 93304-3114
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Country | US
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Telephone | 661-323-0076
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Fax | 661-323-0277
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Authorized Official
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Title or Position | GENERAL DENTIST
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Name | DR. MA LOURDES ANDRES-JAVIER
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Credential | DMD
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Telephone | 818-247-9905
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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 | 39016
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License Number State | CA
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