Individual
DR. DANIEL AUTENCIO MABAET
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DENTIST
Contact information
Practice address
285 MARE ISLAND WAY, VALLEJO, CA 94590-9459
(707) 552-2228
(707) 553-9847
Mailing address
285 MARE ISLAND WAY, VALLEJO, CA 94590-5897
(707) 552-2228
(707) 553-9847
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
102760
CA
Other
Enumeration date
08/01/2018
Last updated
08/01/2018
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