Individual
DR. EDEGAR VERGARA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
2340 MCKEE RD STE 3, SAN JOSE, CA 95116-1615
(669) 284-9988
Mailing address
4621 CAPITAN DR, FREMONT, CA 94536-5447
(510) 585-7977
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
30-024422
OH
122300000X
Dentist
Primary
63272
CA
Other
Enumeration date
03/03/2014
Last updated
04/16/2018
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