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General NPI Number Information
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NPI Number | 1972285591
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Entity Type | Organization
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Legal Business Name | RODOLFO ORTEZA JR DDS PC
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Dates
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Enumeration Date | 08/03/2023
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Last Update Date | 08/03/2023
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Provider Practice Location Address
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Address Line | 5172 MOWRY AVENUE
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City | FREMONT
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State | CA
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Zip | 94538
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Country | US
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Telephone | 510-505-9465
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Fax | 510-505-1206
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Provider Business Mailing Address
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Address Line | 39447 ROYAL PALM DRIVE
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City | FREMONT
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State | CA
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Zip | 94538
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Country | US
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Telephone | 510-432-2055
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Fax |
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Authorized Official
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Title or Position | DENTIST
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Name | RODOLFO ORTEZA JR.
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Credential | DDS.
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Telephone | 510-432-2055
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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 |
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License Number State |
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