Organization
BR PUCAN II PROFESSIONAL DENTAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRISBAIN RIGOR PUCAN (DENTIST/OWNER)
(707) 552-3952
Entity
Organization
Contact information
Practice address
1581 SYCAMORE AVE STE 3, HERCULES, CA 94547-1700
(510) 671-8111
Mailing address
2143 SPRINGS RD. SUITE 51, VALLEJO, CA 94591
(707) 552-3952
(707) 552-9320
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
09/20/2019
Last updated
12/16/2019
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