Fung, Glenn S

Fung, Glenn S is an individual health care provider with primary practice located at 885 Markham Ave , Vacaville CA 95688-2988. He recently has 2 registered licenses in different health care specialties including Dental Providers / General Practice, Dental Providers / Dentist. Dental Providers / Dentist is his primary health care specialty. Fung, Glenn S can be contacted via phone (707) 448-8851.

Contact Information

Primary practice address
885 Markham Ave Vacaville CA 95688-2988
Phone: (707) 448-8851
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X 39957 California
Dental Providers / Dentist 122300000X 055882 New York

Profile Details

NPI number 1376600205
LBN Legal business name Fung, Glenn S
Credentials Doctor of Dental Medicine (DMD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 2nd, 2007
Last updated Dec 19th, 2011 - about 14 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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Identifiers

StateTypeNumberIssuer
All States NPI 1376600205 NPPES
California Other B39957-01 DENTI-CAL
California Other 055882 DENTI-CAL

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