BR Pucan II Professional Dental Corporation
Organization Active NPI Dental Clinic/Center · Hercules, CA
NPI 1366093460 · NPPES record last updated Dec 16, 2019
Key facts
- NPI
- 1366093460
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Dental Clinic/Center 261QD0000X
- Legal business name
- BR PUCAN II PROFESSIONAL DENTAL CORPORATION
- Practice address
- 1581 Sycamore Ave Ste 3
Hercules, CA 94547-1700 - Phone
- (510) 671-8111
- NPI assigned
- Sep 20, 2019
- Organization subpart
- No
Authorized official
- Name
- Brisbain Rigor Pucan
- Title
- Dentist/Owner
- Phone
- (707) 552-3952
Practitioners 1
-
Brisbain Rigor Pucan, DMD
National Provider Directory
Locations
1581 Sycamore Ave
Ste 3
Hercules, CA 94547
Phone (510) 671-8111
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dental Clinic/Center | 261QD0000X | Yes |
Addresses
Primary practice location
1581 Sycamore Ave Ste 3
Hercules, CA 94547-1700
Mailing address
2143 Springs Rd. Suite 51
Vallejo, CA 94591
Phone (707) 552-3952
Other providers in Hercules, CA
- Blize Healthcare California Inc.
- Blize Healthcare California Inc.
- BM Behavioral Center
- Ann Bonner
- Benece Juanda Booker
- Darren Bracey
- Ayante Braggs
- Boris Yakov Brand
- Caryn Ann Brock
- Jayland Rudolph Brooks
All providers in Hercules, CA · Dental Clinic/Center in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 16, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.