Individual
DR. JAC W PEDERSEN II
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
3221 S HIGUERA ST, STE. 100, SAN LUIS OBISPO, CA 93401-6924
(805) 544-8111
(805) 544-6309
Mailing address
3221 S HIGUERA ST, STE. 100, SAN LUIS OBISPO, CA 93401-6924
(805) 544-8111
(805) 544-6309
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
27472
CA
Other
Enumeration date
10/21/2008
Last updated
10/21/2008
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