| Blossom Dental Excellence, Inc | |
|
6134 Camino Verde Dr Suite E San Jose CA 95119-1431 | |
| (408) 227-4010 | |
| (408) 227-4011 |
| Full Name | Blossom Dental Excellence, Inc |
|---|---|
| Speciality | Dentist |
| Location | 6134 Camino Verde Dr, San Jose, California |
| Authorized Official Name and Position | Jaswinder Ghuman (PRESIDENT) |
| Authorized Official Contact | 4082274010 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Blossom Dental Excellence, Inc 6134 Camino Verde Dr Suite E San Jose CA 95119-1431 Ph: (408) 227-4010 | Blossom Dental Excellence, Inc 6134 Camino Verde Dr Suite E San Jose CA 95119-1431 Ph: (408) 227-4010 |
| NPI Number | 1093936957 |
|---|---|
| Provider Enumeration Date | 05/01/2007 |
| Last Update Date | 08/13/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093936957 | NPI | - | NPPES |
| 1336159383 | Other | CA | TYPE 1 - NPI NUMBER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 46802 (California) | Primary |
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