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General NPI Number Information
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NPI Number | 1184152324
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Entity Type | Organization
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Legal Business Name | SEAN K. VREEBURG, DDS, MS, PC
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Dates
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Enumeration Date | 06/01/2017
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Last Update Date | 06/01/2017
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Provider Practice Location Address
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Address Line | 3220 BEARD RD STE C
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City | NAPA
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State | CA
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Zip | 94558-3403
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Country | US
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Telephone | 707-252-6077
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Fax | 707-252-7598
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Provider Business Mailing Address
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Address Line | 3220 BEARD RD STE C
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City | NAPA
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State | CA
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Zip | 94558-3403
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Country | US
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Telephone | 707-252-6077
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Fax | 707-252-7598
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. SEAN KEVIN VREEBURG
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Credential | DDS, MS
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Telephone | 707-490-9084
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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 | 63803
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License Number State | CA
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