| Sergio Vicuna Dental Corporation | |
|
4515 Fermi Place Suite 106 Davis CA 95618 | |
| (310) 451-5060 | |
| (310) 451-5062 |
| Full Name | Sergio Vicuna Dental Corporation |
|---|---|
| Speciality | Dentist |
| Location | 4515 Fermi Place Suite 106, Davis, California |
| Authorized Official Name and Position | Sergio Vicuna (OWNER DOCTOR) |
| Authorized Official Contact | 3104515060 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Sergio Vicuna Dental Corporation 17000 Red Hill Avenue Irvine ORANGE 92614 Ph: (714) 845-8890 | Sergio Vicuna Dental Corporation 4515 Fermi Place Suite 106 Davis CA 95618 Ph: (310) 451-5060 |
| NPI Number | 1063841096 |
|---|---|
| Provider Enumeration Date | 11/12/2013 |
| Last Update Date | 11/12/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063841096 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | (* (Not Available)) | Primary |
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