MEDICARE: DR. DANIEL VASQUEZ DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	42706	CA

General Provider Information

NPI Number	:	1073675229
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DANIEL VASQUEZ DDS

Provider Business Mailing Address
First Line	:	3601 VISTA WAY STE 105
Second Line	:
City	:	OCEANSIDE
State	:	CA
Zip	:	92056-4559
Country	:	US
Telephone Number	:	760-529-5339
Fax Number	:	760-231-5134

Provider Business Practice Location Address
First Line	:	3601 VISTA WAY STE 105
Second Line	:
City	:	OCEANSIDE
State	:	CA
Zip	:	92056-4559
Country	:	US
Telephone Number	:	760-529-5339
Fax Number	:	760-231-5134

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/14/2006
Last Update Date	:	03/09/2020

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