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General NPI Number Information
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NPI Number | 1063802833
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Entity Type | Organization
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Legal Business Name | RIK A VANOOTEGHEM DDS, MS
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Dates
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Enumeration Date | 01/30/2015
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Last Update Date | 01/30/2015
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Provider Practice Location Address
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Address Line | 516 W REMINGTON DR STE 5A
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City | SUNNYVALE
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State | CA
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Zip | 94087-2458
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Country | US
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Telephone | 408-738-3423
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Fax | 408-733-5720
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Provider Business Mailing Address
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Address Line | 516 W REMINGTON DR STE 5A
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City | SUNNYVALE
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State | CA
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Zip | 94087-2458
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Country | US
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Telephone | 408-738-3423
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Fax | 408-733-5720
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Authorized Official
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Title or Position | PRESIDENT
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Name | RIK A VANOOTEGHEM I
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Credential | DDS MS
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Telephone | 408-738-3423
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | 033393
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License Number State | CA
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