Individual
DR. ROBERT DOMINGUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
750 N. CAPITOL AVE, C-8, SAN JOSE, CA 95133
(408) 926-2221
(408) 926-8725
Mailing address
750 N. CAPITOL AVE, C-8, SAN JOSE, CA 95133
(408) 926-2221
(408) 926-8725
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
25510
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
77166
UNITED CONCORDIA
—
Enumeration date
08/04/2006
Last updated
07/08/2007
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