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General NPI Number Information
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NPI Number | 1427198043
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Entity Type | Organization
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Legal Business Name | RONALDO E FERMIN DMD INC
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Dates
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Enumeration Date | 02/07/2007
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Last Update Date | 07/13/2020
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Provider Practice Location Address
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Address Line | 2400 WESTBOROUGH BLVD STE 104
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City | SOUTH SAN FRANCISCO
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State | CA
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Zip | 94080-5402
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Country | US
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Telephone | 650-878-1033
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Fax | 650-878-1031
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Provider Business Mailing Address
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Address Line | 2400 WESTBOROUGH BLVD STE 104
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City | SOUTH SAN FRANCISCO
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State | CA
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Zip | 94080-5402
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Country | US
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Telephone | 650-878-1033
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Fax | 650-878-1031
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Authorized Official
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Title or Position | CO OWNER DENTIST ADMINISTRATOR AND
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Name | DR. ALICIA B FERMIN
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Credential | DMD
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Telephone | 650-878-1033
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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 | 35880
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License Number State | CA
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