Jesse M. Fa, Dds, INC

NPI #1104349760 in Antioch, California

Provider Information

NPI Number: 1104349760
Entity Type: Organization
Organization Name: Jesse M. Fa, Dds, INC
Primary Specialty: Dentist - Oral and Maxillofacial Surgery
Enumeration Date: Jul 25, 2017
Last Updated: Mar 17, 2018

Practice Location

Address: 2730 LONE TREE WAY STE 7
City: Antioch
State: California
ZIP Code: 94509-4964
Phone: (925) 757-2217

Authorized Official

Name: DR. JESSE MICHAEL FA, DDS
Title: OWNER
Phone: (925) 757-2217

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - Oral and Maxillofacial Surgery — Oral and Maxillofacial Surgery	1223S0112X	Primary

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