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NPI Code Detail

MEDICARE: ORLANDO J FUGARO DDS MSD PS

MEDICARE: ORLANDO J FUGARO DDS MSD PS
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
1261QD0000XDental Clinic/Center10104WA

General Provider Information

NPI Number : 1689020018
Entity Type Code : Organization
Provider Name (Legal Business Name) : ORLANDO J FUGARO DDS MSD PS
Provider Business Mailing Address
First Line : 710 ERICKSEN AVE NE STE 200
Second Line :
City : BAINBRIDGE ISLAND
State : WA
Zip : 98110-2835
Country : US
Telephone Number : 206-842-2646
Fax Number :
Provider Business Practice Location Address
First Line : 710 ERICKSEN AVE NE STE 200
Second Line :
City : BAINBRIDGE ISLAND
State : WA
Zip : 98110-2835
Country : US
Telephone Number : 206-842-2646
Fax Number :
Authorized Official
Title or Position : OWNER
Name : DR. ORLANDO J FUGARO
Credential : DDS
Telephone Number : 206-842-2646
Provider Enumeration Date : 05/04/2016
Last Update Date : 05/04/2016

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Directions to “ORLANDO J FUGARO DDS MSD PS ” Practice Location

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