Provider Demographics
NPI:1790877702
Name:DEL ROSARIO, AMOR BULANDOZ (DMD)
Entity Type:Individual
Prefix:DR
First Name:AMOR
Middle Name:BULANDOZ
Last Name:DEL ROSARIO
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:47944 WARM SPRINGS BLVD
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94539-7827
Mailing Address - Country:US
Mailing Address - Phone:510-657-4880
Mailing Address - Fax:510-252-0920
Practice Address - Street 1:47944 WARM SPRINGS BLVD
Practice Address - Street 2:
Practice Address - City:FREMONT
Practice Address - State:CA
Practice Address - Zip Code:94539-7827
Practice Address - Country:US
Practice Address - Phone:510-657-4880
Practice Address - Fax:510-252-0920
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-28
Last Update Date:2013-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA421431223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice