Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 1223X0400X | Orthodontists | 055874 | NY |
Y | 1223X0400X | Orthodontists | 60974 | CA |
NPI | 1013285501 |
---|---|
Provider Name | Dr. David William Majeroni |
First Address | Lafayette, CA 94549-2653 |
Second Address | Alamo, CA 94507-1980 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/12/2011 |
Last Update Date | 12/12/2011 |