Organization
HEJLAWY DDS PC
Active
Other names
Blue Oak Endodontics
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SAMER HEJLAWY DDS.MSD (PRESIDENT)
(707) 447-7576
Entity
Organization
Contact information
Practice address
301 ALAMO DR STE D, VACAVILLE, CA 95688-4246
(707) 447-7576
Mailing address
301 ALAMO DR STE D, VACAVILLE, CA 95688-4246
(707) 447-7576
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1528579661
NPI
—
01
—
1902229164
NPI
—
Enumeration date
10/17/2017
Last updated
11/20/2019
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