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Organization
J.A.FAJARDO DDS INC.
Active
Organization
J.A.FAJARDO DDS INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOSE AGAPITO TIU FAJARDO JR. (PRESIDENT/DENTIST)
(626) 582-8818
Entity
Organization
Contact information
Practice address
10920 VALLEY BLVD, EL MONTE, CA 91731-2515
(626) 582-8818
(888) 371-5020
Mailing address
10920 VALLEY BLVD, EL MONTE, CA 91731-2515
(626) 582-8818
(888) 371-5020
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
56587
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1699957696
NPI
CA
Enumeration date
09/20/2010
Last updated
09/20/2010
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