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General NPI Number Information
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NPI Number | 1699127209
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Entity Type | Organization
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Legal Business Name | PHOEBE E. MONTEMAYOR, DDS, INC.
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Dates
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Enumeration Date | 07/07/2016
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Last Update Date | 07/07/2016
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Provider Practice Location Address
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Address Line | 20345 SANTA MARIA AVE
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City | CASTRO VALLEY
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State | CA
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Zip | 94546-4227
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Country | US
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Telephone | 510-537-5229
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Fax |
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Provider Business Mailing Address
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Address Line | 1850 GERANIUM WAY
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City | TRACY
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State | CA
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Zip | 95376-6718
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Country | US
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Telephone | 209-814-3645
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. PHOEBE-ELYN E MONTEMAYOR
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Credential | DDS
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Telephone | 209-814-3645
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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 | 62549
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License Number State | CA
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