Jesse Michael Fa D.D.S

NPI 1629291091 - Student in an Organized Health Care Education/Training Program - 390200000X

NPI Details
NPI 1629291091
Gender Male
Enumeration Date 04/11/2007
Last Updated 06/25/2014
Entity Type Individual
Active Over 9 years ago
Practice Location
2730 LONE TREE WAY
UNIT 7
ANTIOCH CA, 94509-4942, US
Phone (925) 757-2217
Fax
Business Location
2730 LONE TREE WAY
UNIT 7
ANTIOCH CA, 94509-4942, US
Phone (925) 757-2217
Fax
Toxanomy
Taxonomy Code 390200000X
License State
License Number
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According to our database, Dr. Jesse Michael Fa D.D.S NPI is 1629291091, taxonomy code is 390200000X Jesse Michael Fa D.D.S physically located at 2730 Lone Tree Way, Antioch CA, 94509-4942. NPI Number Jesse Michael Fa D.D.S has the Individual type.

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1629291091 NPI number is provided on an as is basis without warranty of any kind. 1629291091 is maintained by the National Plan & Provider Enumeration System. The contents of Jesse Michael Fa D.D.S are for informational purposes only.