Provider Demographics
NPI:1962687715
Name:MACIAS, FRANCISCO JAVIER (DDS)
Entity Type:Individual
Prefix:DR
First Name:FRANCISCO
Middle Name:JAVIER
Last Name:MACIAS
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2232 ROAD 20
Mailing Address - Street 2:
Mailing Address - City:SAN PABLO
Mailing Address - State:CA
Mailing Address - Zip Code:94806-3318
Mailing Address - Country:US
Mailing Address - Phone:510-236-5640
Mailing Address - Fax:510-237-9135
Practice Address - Street 1:2232 ROAD 20
Practice Address - Street 2:
Practice Address - City:SAN PABLO
Practice Address - State:CA
Practice Address - Zip Code:94806-3318
Practice Address - Country:US
Practice Address - Phone:510-236-5640
Practice Address - Fax:510-237-9135
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-28
Last Update Date:2007-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA481461223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice