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Individual

CLARA NANCY ANDIRIOUS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
D.D.S.

Contact information

Practice address
6472 CAMDEN AVE., SUITE 100, SAN JOSE, CA 95120
(408) 997-9027
(408) 997-7852
Mailing address
6472 CAMDEN AVE., SUITE 100, SAN JOSE, CA 95120
(408) 997-9027
(408) 997-7852

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
51545
CA
1223G0001X
General Practice Dentistry
51545
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
G93394-01
CA
Enumeration date
12/12/2006
Last updated
01/29/2016
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