| Br Pucan Ii Professional Dental Corporation | |
|
1581 Sycamore Ave Ste 3 Hercules CA 94547-1700 | |
| (510) 671-8111 | |
| Not Available |
| Full Name | Br Pucan Ii Professional Dental Corporation |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 1581 Sycamore Ave Ste 3, Hercules, California |
| Authorized Official Name and Position | Brisbain Rigor Pucan (DENTIST/OWNER) |
| Authorized Official Contact | 7075523952 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Br Pucan Ii Professional Dental Corporation 2143 Springs Rd. Suite 51 Vallejo CA 94591 Ph: (707) 552-3952 | Br Pucan Ii Professional Dental Corporation 1581 Sycamore Ave Ste 3 Hercules CA 94547-1700 Ph: (510) 671-8111 |
| NPI Number | 1366093460 |
|---|---|
| Provider Enumeration Date | 09/20/2019 |
| Last Update Date | 12/16/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366093460 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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