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General NPI Number Information
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NPI Number | 1265598213
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Entity Type | Organization
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Legal Business Name | JAMES R. MUSSER, DDS, INC.
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Dates
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Enumeration Date | 12/27/2006
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Last Update Date | 11/17/2014
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Provider Practice Location Address
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Address Line | 10425 FAIR OAKS BLVD SUITE 101
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City | FAIR OAKS
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State | CA
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Zip | 95628-7559
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Country | US
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Telephone | 916-965-3077
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Fax | 916-965-3079
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Provider Business Mailing Address
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Address Line | 10425 FAIR OAKS BLVD SUITE 101
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City | FAIR OAKS
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State | CA
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Zip | 95628-7559
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Country | US
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Telephone | 916-965-3077
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Fax | 916-965-3079
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JAMES R. MUSSER
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Credential | DDS
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Telephone | 916-965-3077
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 21487
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License Number State | CA
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