| Organization Name: | CABUGAO DDS INC |
| NPI Number: | 1669848727 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | KEVIN JAMES CABUGAO (PRESIDENT) |
| Mailing Address: | 6040 Main St Suite 146 American Canyon |
| State: | CA US |
| Postal Code: | 945031390 |
| Phone Number: | 7075624090 |
| Fax Number: | 7075624099 |
| NPI Enumeration Date: | 08/12/2015 |
| NPI Last Update Date: | 08/12/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QD0000X |
| License Number: | 58945 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Dental |
| Taxonomy Definition: | |