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General NPI Number Information
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NPI Number | 1144251307
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Entity Type | Organization
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Legal Business Name | ADAM J. JANETTE, DDS INC.
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Dates
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Enumeration Date | 07/06/2006
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Last Update Date | 06/30/2008
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Provider Practice Location Address
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Address Line | 77 CASA ST SUITE 101
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City | SAN LUIS OBISPO
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State | CA
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Zip | 93405-5803
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Country | US
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Telephone | 805-541-5611
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Fax | 805-541-2328
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Provider Business Mailing Address
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Address Line | 77 CASA ST SUITE 101
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City | SAN LUIS OBISPO
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State | CA
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Zip | 93405-5803
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Country | US
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Telephone | 805-541-5611
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Fax | 805-541-2328
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Authorized Official
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Title or Position | DDS/OWNER
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Name | DR. ADAM JOSEPH JANETTE
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Credential | DDS
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Telephone | 805-541-5611
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | 44324
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License Number State | CA
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