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General NPI Number Information
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NPI Number | 1821124603
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Entity Type | Organization
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Legal Business Name | MARIA ESPERANZA LABAO DDS INC
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Dates
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Enumeration Date | 02/26/2007
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Last Update Date | 12/10/2012
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Provider Practice Location Address
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Address Line | 1590 EL CAMINO REAL SUITE A
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City | SAN BRUNO
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State | CA
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Zip | 94066
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Country | US
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Telephone | 650-873-6798
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Fax | 650-873-6643
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Provider Business Mailing Address
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Address Line | 1590 EL CAMINO REAL SUITE A
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City | SAN BRUNO
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State | CA
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Zip | 94066
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Country | US
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Telephone | 650-873-6798
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Fax | 650-873-6643
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Authorized Official
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Title or Position | OWNER DENTIST
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Name | DR. MARIA ESPERANZA LABAO
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Credential | DDS
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Telephone | 650-873-6798
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 46853
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License Number State | CA
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