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General NPI Number Information
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NPI Number | 1821284969
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Entity Type | Individual
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Provider Name | MIGUEL ARTURO ZEVALLOS DDS
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Gender | Male
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Dates
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Enumeration Date | 09/21/2007
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Last Update Date | 01/24/2010
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Provider Practice Location Address
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Address Line | 4251 S HIGUERA ST SUITE 502
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City | SAN LUIS OBISPO
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State | CA
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Zip | 93401-7700
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Country | US
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Telephone | 805-540-5251
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Fax |
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Provider Business Mailing Address
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Address Line | 2250 KING CT # 51
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City | SAN LUIS OBISPO
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State | CA
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Zip | 93401-5506
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Country | US
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Telephone | 805-439-0260
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 56305
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License Number State | CA
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