Fred Lynn Egelston DDS

NPI 1053443200 - Dentist - 122300000X

NPI Details
NPI 1053443200
Gender Male
Enumeration Date 03/12/2007
Last Updated 07/08/2007
Entity Type Individual
Active Over 9 years ago
Practice Location
6501 CROWN BLVD STE 202
SAN JOSE CA, 95120-2903, US
Phone (408) 268-7000
Fax (408) 268-8590
Business Location
6501 CROWN BLVD STE 202
SAN JOSE CA, 95120-2903, US
Phone (408) 268-7000
Fax (408) 268-8590
Toxanomy
Taxonomy Code 122300000X
License State California
License Number 031779
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According to our database, Dr. Fred Lynn Egelston DDS NPI is 1053443200, taxonomy code is 122300000X and license number is 031779, license state is located at California. Fred Lynn Egelston DDS physically located at 6501 Crown Blvd Ste 202, San Jose CA, 95120-2903. NPI Number Fred Lynn Egelston DDS has the Individual type.

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1053443200 NPI number is provided on an as is basis without warranty of any kind. 1053443200 is maintained by the National Plan & Provider Enumeration System. The contents of Fred Lynn Egelston DDS are for informational purposes only.