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General NPI Number Information
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NPI Number | 1346520616
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Entity Type | Organization
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Legal Business Name | JAMES E. GENOBAGA, DDS, INC.
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Dates
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Enumeration Date | 08/18/2011
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Last Update Date | 08/18/2011
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Provider Practice Location Address
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Address Line | 367 DEL NORTE AVE SUITE 1
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City | YUBA CITY
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State | CA
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Zip | 95991-4116
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Country | US
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Telephone | 530-763-4231
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Fax | 530-763-4316
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Provider Business Mailing Address
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Address Line | 367 DEL NORTE AVE SUITE 1
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City | YUBA CITY
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State | CA
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Zip | 95991-4116
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Country | US
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Telephone | 530-763-4231
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Fax | 530-763-4316
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Authorized Official
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Title or Position | OWNER/DENTIST
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Name | DR. JAMES E. GENOBAGA I
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Credential | DDS
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Telephone | 530-763-4231
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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 | 51409
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License Number State | CA
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