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87 Fenton St Ste 105 Livermore CA 94550-4100 | |
| (925) 292-5231 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 87 Fenton St, Livermore, California |
| Authorized Official Name and Position | Lisa Mary Nguyen (DENTIST) |
| Authorized Official Contact | 9252925231 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
87 Fenton St Ste 105 Livermore CA 94550-4100 Ph: (925) 292-5231 | 87 Fenton St Ste 105 Livermore CA 94550-4100 Ph: (925) 292-5231 |
| NPI Number | 1467705533 |
|---|---|
| Provider Enumeration Date | 10/26/2012 |
| Last Update Date | 10/26/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467705533 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 57669 (California) | Primary |
| 1223G0001X | Dentist - General Practice | 58727 (California) | Secondary |
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