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General NPI Number Information
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NPI Number | 1669381489
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Entity Type | Organization
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Legal Business Name | DARYL DUDUM DDS INC
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Dates
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Enumeration Date | 09/07/2026
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Last Update Date | 09/07/2026
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Provider Practice Location Address
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Address Line | 1748 NOVATO BLVD STE 200
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City | NOVATO
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State | CA
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Zip | 94947-7855
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Country | US
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Telephone | 415-898-0563
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Fax | 415-898-0563
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Provider Business Mailing Address
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Address Line | 1748 NOVATO BLVD STE 200
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City | NOVATO
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State | CA
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Zip | 94947-7855
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Country | US
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Telephone | 415-898-7093
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Fax | 415-898-0563
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Authorized Official
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Title or Position | VP, PAYOR RELATIONS
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Name | MICHAELA MUNIZ
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Credential |
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Telephone | 469-324-3242
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223E0200X
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Taxonomy Name | Endodontics
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License Number |
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License Number State |
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