Br Pucan II Professional Dental Corporation
NPI #1366093460 in Hercules, California
Provider Information
- NPI Number
- 1366093460
- Entity Type
- Organization
- Organization Name
- Br Pucan II Professional Dental Corporation
- Primary Specialty
- Clinic/Center - Dental
- Enumeration Date
- Sep 20, 2019
- Last Updated
- Dec 16, 2019
Practice Location
- Address
- 1581 SYCAMORE AVE STE 3
- City
- Hercules
- State
- California
- ZIP Code
- 94547-1700
- Phone
- (510) 671-8111
Authorized Official
- Name
- BRISBAIN RIGOR PUCAN
- Title
- DENTIST/OWNER
- Phone
- (707) 552-3952
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinic/Center - Dental — Dental |
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