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Organization
CUPERTINO DENTAL SPECIALTY GROUP
Active
Organization
CUPERTINO DENTAL SPECIALTY GROUP
Active
Parent organization
CUPERTINO DENTAL GROUP PARTNERSHIP
Other names
Cupertino Dental Group
Organization subpart
Yes
Provider details
NPI number
Legal business name
CUPERTINO DENTAL GROUP PARTNERSHIP
Authorized official
MELINA LUCCHINI (SUPERVISOR)
(408) 257-3031
Entity
Organization
Contact information
Practice address
10373 TORRE AVENUE, SUITE G, CUPERTINO, CA 95014-9501
(408) 508-7560
(408) 508-7530
Mailing address
10383 TORRE AVE STE I, CUPERTINO, CA 95014-3238
(408) 257-3031
(408) 508-7530
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
—
NULL
1223E0200X
Endodontics
—
—
1223P0300X
Periodontics
—
NULL
1223P0300X
Periodontics
—
—
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
NULL
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
—
Other
Enumeration date
02/02/2022
Last updated
02/02/2022
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