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General NPI Number Information
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NPI Number | 1528495009
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Entity Type | Organization
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Legal Business Name | NICANOR J. BATISTA DDS. INC.
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Dates
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Enumeration Date | 09/30/2013
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Last Update Date | 09/30/2013
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Provider Practice Location Address
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Address Line | 41539 KALMIA ST., STE 103
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City | MURRIETA
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State | CA
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Zip | 92562
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Country | US
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Telephone | 951-445-4040
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Fax | 951-445-4037
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Provider Business Mailing Address
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Address Line | 41539 KALMIA ST., STE 103
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City | MURRIETA
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State | CA
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Zip | 92562
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Country | US
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Telephone | 951-445-4040
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Fax | 951-445-4037
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. NICANOR JEBUNAN BAUTISTA
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Credential | DDS
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Telephone | 951-445-4040
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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 | 50727
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License Number State | CA
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