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1326113291
GENESIS PROFETA ANTONIO
FAIRFIELD, CA
NPI
1326113291
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
1223G0001X Dentist, General Practice
(Licence: CA 48076)
Enumeration Date
2006-11-22
Last Update Date
2007-07-08
Business 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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Mailing Address
-- GENESIS PROFETA ANTONIO D.D.S.
650 EMPIRE ST SUITE B
FAIRFIELD, CA 94533-5527
Phone number: 707-428-7171
Copy
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