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Organization
JAQUERY DENTAL INC.
Active
Organization
JAQUERY DENTAL INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VINICIUS A JAQUERY (SECRETARY)
(831) 722-8469
Entity
Organization
Contact information
Practice address
56 PENNY LN STE C, WATSONVILLE, CA 95076-6018
(831) 722-8469
(831) 722-0241
Mailing address
56 PENNY LN STE C, WATSONVILLE, CA 95076-6018
(831) 722-8469
(831) 722-0241
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1558550954
NPPES
—
Enumeration date
11/04/2019
Last updated
11/04/2019
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