Organization
DENNIS J. WIDMAN, DDS, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DENNIS JORDAN WIDMAN D.D.S. (PRESIDENT)
(408) 265-4480
Entity
Organization
Contact information
Practice address
4860 CHERRY AVE, SUITE B, SAN JOSE, CA 95118-3716
(408) 265-4480
(408) 997-2946
Mailing address
4860 CHERRY AVE, SUITE B, SAN JOSE, CA 95118-3716
(408) 265-4480
(408) 997-2946
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
18666
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
D18666
MEDICAL, DENTICAL
CA
Enumeration date
10/05/2007
Last updated
10/05/2007
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