Provider Demographics
NPI:1336328525
Name:DR. DAY DENTAL OFFICE, APC
Entity Type:Organization
Organization Name:DR. DAY DENTAL OFFICE, APC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:EDITHA
Authorized Official - Middle Name:LEGASPI
Authorized Official - Last Name:BOONGALING
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:707-552-8684
Mailing Address - Street 1:2900 SONOMA BLVD
Mailing Address - Street 2:SUITE A
Mailing Address - City:VALLEJO
Mailing Address - State:CA
Mailing Address - Zip Code:94590-3810
Mailing Address - Country:US
Mailing Address - Phone:707-552-8684
Mailing Address - Fax:707-552-2980
Practice Address - Street 1:2900 SONOMA BLVD
Practice Address - Street 2:SUITE A
Practice Address - City:VALLEJO
Practice Address - State:CA
Practice Address - Zip Code:94590-3810
Practice Address - Country:US
Practice Address - Phone:707-552-8684
Practice Address - Fax:707-552-2980
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-24
Last Update Date:2007-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA406531223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty