Organization
WEST COAST DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KRYSTAL HERNANDEZ (OFFICE MANAGER)
(408) 424-2200
Entity
Organization
Contact information
Practice address
3571 N 1ST ST STE 203, SAN JOSE, CA 95134-1803
(408) 424-2200
Mailing address
3571 N 1ST ST STE 203, SAN JOSE, CA 95134-1803
Taxonomy
Speciality
Code
Description
License number
State
126800000X
Dental Assistant
Primary
76347
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
126800000X
DENTAL
CA
01
—
1649611591
DENTAL PROVIDER
CA
Enumeration date
01/09/2015
Last updated
01/09/2015
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