GENESIS PROFETA ANTONIO

FAIRFIELD, CA
NPI1326113291
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy1223G0001X Dentist, General Practice
(Licence: CA  48076)
Enumeration Date2006-11-22
Last Update Date2007-07-08
Business Address
-- GENESIS PROFETA ANTONIO D.D.S.
650 EMPIRE ST SUITE B
FAIRFIELD, CA 94533-5527
Phone number: 707-428-7171
Mailing Address
-- GENESIS PROFETA ANTONIO D.D.S.
650 EMPIRE ST SUITE B
FAIRFIELD, CA 94533-5527
Phone number: 707-428-7171
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