Organization
JAIRO SEPULVEDA DDS, INC.
Active
Other names
Jairo Sepulveda DDS, Inc.
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAIRO GIOVANNI SEPULVEDA DENTIST (DENTIST/ OWNER)
(559) 562-5969
Entity
Organization
Contact information
Practice address
233 S MIRAGE AVE, LINDSAY, CA 93247-2543
(559) 562-5969
(559) 562-2358
Mailing address
233 S MIRAGE AVE, LINDSAY, CA 93247-2543
(559) 562-5969
(559) 562-2358
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
49802
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1114091162
MEDICAL
CA
Enumeration date
11/28/2017
Last updated
11/28/2017
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