Organization Name: | CECILIA TOPACIO FEJARANG, DMD, INC. |
NPI Number: | 1003136722 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | CECILIA TOPACIO FEJARANG (PRESIDENT) |
Mailing Address: | 141 Sand Creek Rd Suite G Brentwood |
State: | CA US |
Postal Code: | 945137390 |
Phone Number: | 9255220099 |
Fax Number: | 9255220084 |
NPI Enumeration Date: | 06/03/2010 |
NPI Last Update Date: | 05/03/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QD0000X |
License Number: | 39718 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Dental |
Taxonomy Definition: |