| Robert Matiasevich Jr Dds Inc | |
|
1775 Dominican Way Santa Cruz CA 95065 | |
| (831) 476-7272 | |
| (831) 476-1446 |
| Full Name | Robert Matiasevich Jr Dds Inc |
|---|---|
| Speciality | Dentist |
| Location | 1775 Dominican Way, Santa Cruz, California |
| Authorized Official Name and Position | Robert N Matiasevich (DENTIST) |
| Authorized Official Contact | 8314767272 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Robert Matiasevich Jr Dds Inc 1775 Dominican Way Santa Cruz CA 95065 Ph: (831) 476-7272 | Robert Matiasevich Jr Dds Inc 1775 Dominican Way Santa Cruz CA 95065 Ph: (831) 476-7272 |
| NPI Number | 1235278441 |
|---|---|
| Provider Enumeration Date | 02/05/2007 |
| Last Update Date | 02/17/2017 |
| Medicare PECOS PAC ID | 2365728292 |
|---|---|
| Medicare Enrollment ID | O20170407001394 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235278441 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 21480 (California) | Primary |
| Provider Name | Robert Matiasevich |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1598805996 PECOS PAC ID: 3274819107 Enrollment ID: I20170407001454 |
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