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Organization
DENNIS J. WIDMAN, DDS, INC.
Active
Organization
DENNIS J. WIDMAN, DDS, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DENNIS JORDAN WIDMAN D.D.S. (PRESIDENT)
(408) 265-4480
Entity
Organization
Contact information
Practice address
4860 CHERRY AVE, SUITE B, SAN JOSE, CA 95118-3716
(408) 265-4480
(408) 997-2946
Mailing address
4860 CHERRY AVE, SUITE B, SAN JOSE, CA 95118-3716
(408) 265-4480
(408) 997-2946
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
18666
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
D18666
MEDICAL, DENTICAL
CA
Enumeration date
10/05/2007
Last updated
10/05/2007
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