Individual
DR. JAY FEDOROWICZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
101 BODIN CIR, FAIRFIELD, CA 94535-1809
(074) 237-1037
Mailing address
101 BODIN CIR, FAIRFIELD, CA 94535-1809
(707) 423-7103
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
9711
WA
Other
Enumeration date
10/26/2005
Last updated
11/09/2021
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