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General NPI Number Information
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NPI Number | 1962878033
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Entity Type | Organization
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Legal Business Name | FRIZ J DIAZ, DDS, INC.
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Dates
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Enumeration Date | 08/12/2015
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Last Update Date | 08/12/2015
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Provider Practice Location Address
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Address Line | 77 CADILLAC DR SUITE 165
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City | SACRAMENTO
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State | CA
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Zip | 95825-5453
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Country | US
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Telephone | 916-480-0522
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Fax | 916-480-0524
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Provider Business Mailing Address
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Address Line | 77 CADILLAC DR SUITE 165
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City | SACRAMENTO
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State | CA
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Zip | 95825-5453
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Country | US
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Telephone | 916-480-0522
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Fax | 916-480-0524
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MERWIN DIAZ
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Credential |
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Telephone | 916-480-0522
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 44669
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License Number State | CA
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