Fagan, Mark Charles

Fagan, Mark Charles is an individual health care provider with primary practice located at 1660 Willow St Ste #3, San Jose CA 95125-5101. He recently has only one registered license in Dental Providers / Periodontics, which is considered as his primary health care specialty. Fagan, Mark Charles can be contacted via phone (408) 269-1060.

Contact Information

Primary practice address
1660 Willow St Ste #3 San Jose CA 95125-5101
Phone: (408) 269-1060
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Periodontics 1223P0300X 38419 California

Profile Details

NPI number 1376562827
LBN Legal business name Fagan, Mark Charles
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 18th, 2006
Last updated Jul 8th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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