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General NPI Number Information
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NPI Number | 1841515319
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Entity Type | Organization
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Legal Business Name | EMMANUEL OSORIO, DDS, INC.
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Dates
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Enumeration Date | 03/29/2010
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Last Update Date | 03/29/2010
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Provider Practice Location Address
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Address Line | 5423 SAN JUAN AVE
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City | CITRUS HEIGHTS
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State | CA
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Zip | 95610-7418
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Country | US
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Telephone | 916-962-1200
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Fax |
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Provider Business Mailing Address
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Address Line | 5423 SAN JUAN AVE
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City | CITRUS HEIGHTS
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State | CA
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Zip | 95610-7418
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Country | US
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Telephone | 916-962-1200
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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. EMMANUEL OSORIO
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Credential | D.D.S.
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Telephone | 916-962-1200
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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 | 55707
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License Number State | CA
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