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General NPI Number Information
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NPI Number | 1811181951
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Entity Type | Organization
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Legal Business Name | ROSE M. FELICIANO DMD INC
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Dates
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Enumeration Date | 08/31/2007
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Last Update Date | 07/30/2008
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Provider Practice Location Address
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Address Line | 2577 N 1ST ST
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City | SAN JOSE
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State | CA
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Zip | 95131-1003
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Country | US
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Telephone | 140-843-3555
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Fax | 408-433-0848
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Provider Business Mailing Address
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Address Line | 2577 N 1ST ST
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City | SAN JOSE
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State | CA
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Zip | 95131-1003
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Country | US
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Telephone | 140-843-3555
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Fax | 408-433-0848
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Authorized Official
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Title or Position | DENTIST
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Name | DR. ROSE M FELICIANO
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Credential | DMD
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Telephone | 408-433-5555
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | 38993
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License Number State | CA
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