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General NPI Number Information
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NPI Number | 1679893556
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Entity Type | Organization
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Legal Business Name | ROSE JOY ENDONILA DDS,PROFESSIONAL DENTAL CORPORATION
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Dates
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Enumeration Date | 06/02/2010
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Last Update Date | 06/03/2010
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Provider Practice Location Address
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Address Line | 91 GREGORY LN SUITE 9
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City | PLEASANT HILL
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State | CA
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Zip | 94523-4981
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Country | US
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Telephone | 925-671-9177
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Fax | 925-726-2479
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Provider Business Mailing Address
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Address Line | 91 GREGORY LN SUITE 9
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City | PLEASANT HILL
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State | CA
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Zip | 94523-4981
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Country | US
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Telephone | 925-671-9177
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Fax | 925-726-2479
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Authorized Official
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Title or Position | CEO-PRESIDENT
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Name | DR. ROSE JOY ENDONILA
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Credential | DDS
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Telephone | 925-671-9177
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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 | 44867
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License Number State | CA
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