Organization
BLOSSOM DENTAL EXCELLENCE, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JASWINDER GHUMAN D.D.S. (PRESIDENT)
(408) 227-4010
Entity
Organization
Contact information
Practice address
6134 CAMINO VERDE DR, SUITE E, SAN JOSE, CA 95119-1431
(408) 227-4010
(408) 227-4011
Mailing address
6134 CAMINO VERDE DR, SUITE E, SAN JOSE, CA 95119-1431
(408) 227-4010
(408) 227-4011
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
46802
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1336159383
TYPE 1 - NPI NUMBER
CA
Enumeration date
05/01/2007
Last updated
08/13/2007
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