Individual
MR. AMOS BENJAMIN ACEVEDO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
21890 COLORADO AVE., SAN JOAQUIN, CA 93660
(559) 693-2467
(559) 693-2398
Mailing address
774 CUESTA ST, MORRO BAY, CA 93442-1783
(805) 704-3591
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
27943
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
FHC03875F
—
CA
Enumeration date
03/02/2007
Last updated
07/08/2007
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