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General NPI Number Information
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NPI Number | 1124234406
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Entity Type | Organization
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Legal Business Name | ADVANTA DENTAL CARE
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Dates
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Enumeration Date | 05/15/2007
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Last Update Date | 06/16/2008
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Provider Practice Location Address
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Address Line | 22535 SECOND ST.
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City | HAYWARD
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State | CA
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Zip | 94541
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Country | US
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Telephone | 510-889-6900
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Fax |
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Provider Business Mailing Address
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Address Line | 22535 SECOND ST.
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City | HAYWARD
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State | CA
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Zip | 94541
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Country | US
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Telephone | 510-889-6900
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | FARNK M. VARGAS
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Credential |
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Telephone | 510-889-6900
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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 |
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License Number State |
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