Provider Demographics
NPI:1013324789
Name:TEJERO-UGAY, CRESCENCIA MARIE (DDS)
Entity Type:Individual
Prefix:DR
First Name:CRESCENCIA MARIE
Middle Name:
Last Name:TEJERO-UGAY
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5155 STEVENS CREEK BLVD
Mailing Address - Street 2:STE 100
Mailing Address - City:SANTA CLARA
Mailing Address - State:CA
Mailing Address - Zip Code:95051-6668
Mailing Address - Country:US
Mailing Address - Phone:408-645-5551
Mailing Address - Fax:408-645-5661
Practice Address - Street 1:5155 STEVENS CREEK BLVD
Practice Address - Street 2:STE 100
Practice Address - City:SANTA CLARA
Practice Address - State:CA
Practice Address - Zip Code:95051-6668
Practice Address - Country:US
Practice Address - Phone:408-645-5551
Practice Address - Fax:408-645-5661
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-15
Last Update Date:2016-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA63556122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist