Provider Demographics
NPI:1750617775
Name:CABUGAO, KEVIN JAMES (MBA, DDS)
Entity type:Individual
Prefix:DR
First Name:KEVIN
Middle Name:JAMES
Last Name:CABUGAO
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Gender:M
Credentials:MBA, DDS
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Mailing Address - Street 1:6040 MAIN ST
Mailing Address - Street 2:SUITE 146
Mailing Address - City:AMERICAN CANYON
Mailing Address - State:CA
Mailing Address - Zip Code:94503-1390
Mailing Address - Country:US
Mailing Address - Phone:707-562-4090
Mailing Address - Fax:707-562-4099
Practice Address - Street 1:6040 MAIN ST
Practice Address - Street 2:SUITE 146
Practice Address - City:AMERICAN CANYON
Practice Address - State:CA
Practice Address - Zip Code:94503-1390
Practice Address - Country:US
Practice Address - Phone:707-562-4090
Practice Address - Fax:707-562-4099
Is Sole Proprietor?:No
Enumeration Date:2009-10-27
Last Update Date:2020-04-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CA589451223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice