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DR. SOFRONIO TOLENTINO BANATAO D.M.D.
General Practice >> Dentist >> Dental ProvidersRegistrant NPI Number: 1295892388
Individual Registrant:DR. SOFRONIO TOLENTINO BANATAO D.M.D.
Gender: M
Sole Proprietor
Gender: M
Sole Proprietor
Location and contact information for practice:
35124 NEWARK BLVD NEWARK, CA 94560-1220 US
Tel: 510-796-3441 Fax: 510-796-3475
Tel: 510-796-3441 Fax: 510-796-3475
Contact information for business:
35124 NEWARK BLVD NEWARK, CA 94560-1220 US
Tel: 510-796-3441 Fax: 510-796-3475
Tel: 510-796-3441 Fax: 510-796-3475
Registration Information:
NPI: 1295892388
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 1223G0001X | Dental Providers Dentist General Practice | CA | 38797 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
