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General NPI Number Information
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NPI Number | 1881844660
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Entity Type | Organization
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Legal Business Name | DENTISTRY 2000 & BEYOND, INC.
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Dates
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Enumeration Date | 09/29/2008
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Last Update Date | 09/29/2008
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Provider Practice Location Address
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Address Line | 1708 FRANKLIN ST
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City | OAKLAND
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State | CA
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Zip | 94612-3408
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Country | US
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Telephone | 510-465-7777
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Fax | 510-465-1442
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Provider Business Mailing Address
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Address Line | 1708 FRANKLIN ST
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City | OAKLAND
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State | CA
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Zip | 94612-3408
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Country | US
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Telephone | 510-465-7777
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Fax | 510-465-1442
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Authorized Official
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Title or Position | DENTIST/OWNER
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Name | WENDELL P FUDGEN JR.
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Credential |
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Telephone | 510-465-7777
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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 | 22883
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License Number State | CA
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