Individual
DR. JESSE MICHAEL FA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S
Contact information
Practice address
2201 BALFOUR RD STE E, BRENTWOOD, CA 94513-4927
(925) 308-7908
(925) 308-7910
Mailing address
317 WINDMILL CANYON PL, CLAYTON, CA 94517-1904
(415) 519-5620
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
55360
CA
Other
Enumeration date
04/11/2007
Last updated
04/08/2020
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