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General NPI Number Information
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NPI Number | 1306964366
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Entity Type | Individual
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Provider Name | JUAN JOSE ALZATE DDS
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Gender | Male
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Dates
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Enumeration Date | 03/27/2007
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Last Update Date | 03/01/2018
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Provider Practice Location Address
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Address Line | 5640 N FRESNO ST STE 101
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City | FRESNO
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State | CA
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Zip | 93710-6098
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Country | US
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Telephone | 559-447-5781
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Fax | 559-272-0370
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Provider Business Mailing Address
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Address Line | 5640 N FRESNO ST STE 101
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City | FRESNO
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State | CA
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Zip | 93710-6098
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Country | US
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Telephone | 559-447-5781
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Fax | 559-272-0370
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 505558
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License Number State | CA
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