Individual
PERCIVAL MAGPUSAO MANZANO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDM
Contact information
Practice address
3000 ALAMO DR STE 108, VACAVILLE, CA 95687-6345
(170) 746-9852
Mailing address
3000 ALAMO DR STE 108, VACAVILLE, CA 95687-6345
(170) 746-9852
Taxonomy
Speciality
Code
Description
License number
State
122400000X
Denturist
Primary
18901
CA
Other
Enumeration date
08/05/2009
Last updated
08/05/2009
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