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Organization

BIG SMILE DENTAL GROUP, PC BY EVANGELINE M. MEMORACION D.D.S.

Active
Other names
Big Smile Dental
Organization subpart
No

Provider details

NPI number
Authorized official
EVANGELINE MEMORACION D.D.S. (OWNER)
(408) 600-5722
Entity
Organization

Contact information

Practice address
22429 FOOTHILL BLVD, HAYWARD, CA 94541-4024
(408) 600-5722
Mailing address
22429 FOOTHILL BLVD, HAYWARD, CA 94541-4024
(408) 600-5722

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
56995
CA

Other

Enumeration date
10/28/2015
Last updated
10/28/2015
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