Organization
JESSE M. FA, DDS, INC
Active
Other names
Blue Oak Oral Surgery & Dental Implant Center
Organization subpart
No
Provider details
NPI number
Authorized official
JESSE MICHAEL FA DDS (OWNER)
(925) 757-2217
Entity
Organization
Contact information
Practice address
2201 BALFOUR RD STE E, BRENTWOOD, CA 94513-4927
(925) 308-7908
(925) 308-7910
Mailing address
2201 BALFOUR RD STE E, BRENTWOOD, CA 94513-4927
(925) 308-7908
(925) 308-7910
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
55360
CA
Other
Enumeration date
08/05/2014
Last updated
04/08/2020
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