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General NPI Number Information
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NPI Number | 1326213653
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Entity Type | Organization
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Legal Business Name | RONALD T MATSUURA
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Dates
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Enumeration Date | 04/28/2008
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Last Update Date | 04/28/2008
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Provider Practice Location Address
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Address Line | 990 WEST FREMONT AVE SUITE O SUNNYVALE FAMILY DENTAL CENTER
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City | SUNNYVALE
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State | CA
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Zip | 94087
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Country | US
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Telephone | 408-739-8999
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Fax |
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Provider Business Mailing Address
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Address Line | 990 WEST FREMONT AVE SUITE O SUNNYVALE FAMILY DENTAL CENTER
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City | SUNNYVALE
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State | CA
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Zip | 94087
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Country | US
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Telephone | 408-739-8999
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | RONALD T MATSUURA
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Credential | DDS
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Telephone | 408-739-8999
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State | CA
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