Organization
JESSE M. FA, DDS, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JESSE MICHAEL FA DDS (OWNER)
(925) 757-2217
Entity
Organization
Contact information
Practice address
2730 LONE TREE WAY STE 7, ANTIOCH, CA 94509-4964
(925) 757-2217
(925) 757-6417
Mailing address
2730 LONE TREE WAY STE 7, ANTIOCH, CA 94509-4964
(925) 757-2217
(925) 757-6417
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
CA
Other
Enumeration date
07/25/2017
Last updated
03/17/2018
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