| Jesse M. Fa, Dds, Inc | |
|
2730 Lone Tree Way Ste 7 Antioch CA 94509-4964 | |
| (925) 757-2217 | |
| (925) 757-6417 |
| Full Name | Jesse M. Fa, Dds, Inc |
|---|---|
| Speciality | Dentist - Oral And Maxillofacial Surgery |
| Location | 2730 Lone Tree Way Ste 7, Antioch, California |
| Authorized Official Name and Position | Jesse Michael Fa (OWNER) |
| Authorized Official Contact | 9257572217 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Jesse M. Fa, Dds, Inc 2730 Lone Tree Way Ste 7 Antioch CA 94509-4964 Ph: (925) 757-2217 | Jesse M. Fa, Dds, Inc 2730 Lone Tree Way Ste 7 Antioch CA 94509-4964 Ph: (925) 757-2217 |
| NPI Number | 1104349760 |
|---|---|
| Provider Enumeration Date | 07/25/2017 |
| Last Update Date | 03/17/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104349760 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | (California) | Primary |
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