Organization
DENNIS BARBER SHOP
Active
Parent organization
DENNIS PECORELLA
Organization subpart
Yes
Provider details
NPI number
Legal business name
DENNIS PECORELLA
Authorized official
MR. DENNIS DAVID PECORELLA (OWNER)
(707) 447-4927
Entity
Organization
Contact information
Practice address
1007 ALAMO DR, VACAVILLE, CA 95687-5603
(707) 447-4927
(707) 447-2529
Mailing address
1007 ALAMO DR, VACAVILLE, CA 95687-5603
(707) 447-4927
(707) 447-2529
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
Primary
A181199
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ZZZ65425Z
BLUE SHIELD PIN
CA
Enumeration date
02/07/2007
Last updated
06/18/2008
Update your record
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