Bernard J. Indelicato

NPI 1033396007 - Dentist - 122300000X

NPI Details
NPI 1033396007
Gender Male
Enumeration Date 01/22/2008
Last Updated 01/22/2008
Entity Type Individual
Active Over 8 years ago
Practice Location
480 1ST AVE
PORTOLA CA, 96122-9405, US
Phone (530) 832-6600
Fax
Business Location
480 FIRST A VE.
PORTOLA CA, 96122-9406, US
Phone
Fax
Toxanomy
Taxonomy Code 122300000X
License State California
License Number 18116
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According to our database, Bernard J. Indelicato NPI is 1033396007, taxonomy code is 122300000X and license number is 18116, license state is located at California. Bernard J. Indelicato physically located at 480 1st Ave, Portola CA, 96122-9405. NPI Number Bernard J. Indelicato has the Individual type.

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1033396007 NPI number is provided on an as is basis without warranty of any kind. 1033396007 is maintained by the National Plan & Provider Enumeration System. The contents of Bernard J. Indelicato are for informational purposes only.