Individual
EDMUND VELASQUEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
2999 REGENT ST STE 403, BERKELEY, CA 94705-2119
(510) 843-6341
Mailing address
1305 HAMPEL ST, OAKLAND, CA 94602-1204
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
46709
CA
Other
Enumeration date
01/20/2018
Last updated
01/20/2018
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