Dr. Laurie Matiasevich
Dental Public Health
2101 Courage Dr
Fairfield
, California 94533
Dr. Laurie Matiasevich
Dental Public Health
2101 Courage Dr
Fairfield
, California 94533
(707) 784-2126
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About
Features
Specialties
- Dental Public Health
Languages spoken
- English
Location
First Address
- Dr. Laurie Matiasevich
- 5139 Leonardo Ct.
- Fairfield, CA
- Zip : 94534
- Fax : (707) 784-2126
- Phone : (707) 784-2120
Second Address
- Dr. Laurie Matiasevich
- 2101 Courage Dr
- Fairfield, CA
- Zip : 94533
- Fax : (707) 784-2126
- Phone : (707) 784-2120
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 1223D0001X | Dental Public Health | D23013 | CA |
National Provider Identifier
| NPI | 1427139864 |
|---|---|
| Provider Name | Dr. Laurie Matiasevich |
| First Address | Fairfield, CA 94534 |
| Second Address | Fairfield, CA 94533 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 18/10/2006 |
| Last Update Date | 08/07/2007 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.