Individual
DR. JOHN BENJAMIN AVERA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
9059 SOQUEL DR, B, APTOS, CA 95003-4076
(831) 688-1975
Mailing address
9059 SOQUEL DR, B, APTOS, CA 95003-4076
(831) 688-1975
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
28900
CA
Other
Enumeration date
09/27/2006
Last updated
07/08/2007
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