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1376562827
MARK CHARLES FAGAN
SAN JOSE, CA
NPI
1376562827
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
1223P0300X Dentist, Periodontics
(Licence: CA 38419)
Enumeration Date
2006-07-18
Last Update Date
2007-07-08
Business Address
Dr. MARK CHARLES FAGAN D.D.S.
1660 WILLOW ST STE #3
SAN JOSE, CA 95125-5101
Phone number: 408-269-1060
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Mailing Address
Dr. MARK CHARLES FAGAN D.D.S.
1660 WILLOW ST STE #3
SAN JOSE, CA 95125-5101
Phone number: 408-269-1060
Copy
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