Organization
RICHARD A FAGIN DDS A PROFESSIONAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ADAM PETER FAGIN DMD, MD (SURGEON)
(650) 823-9606
Entity
Organization
Contact information
Practice address
235 N SAN MATEO DR STE 600, SAN MATEO, CA 94401-2675
(650) 342-0213
(650) 342-0636
Mailing address
235 N SAN MATEO DR STE 600, SAN MATEO, CA 94401-2675
(650) 342-0213
(650) 342-0636
Taxonomy
Speciality
Code
Description
License number
State
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
—
—
Other
Enumeration date
12/08/2021
Last updated
01/20/2022
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