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Jac W. Pedersen Ii, D.d.s., Inc
Pediatric Dentist in San Luis Obispo, California
NPI 1194803049

Jac W. Pedersen Ii, D.d.s., Inc is a Pediatric Dentist based in San Luis Obispo, CA and is specialized in Pediatric Dentistry. Jac W. Pedersen Ii, D.d.s., Inc practices in San Luis Obispo, CA. The NPI Number for Jac W. Pedersen Ii, D.d.s., Inc is 1194803049 and holds a License No. 27472 (California).

The current practice location address for Jac W. Pedersen Ii, D.d.s., Inc is 620 California Blvd Ste H, San Luis Obispo, CA and can be reached out via phone at 805-544-8111 and via fax at 805-544-6309.

Location: 620 California Blvd Ste H, San Luis Obispo, CA, 93401-2500
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1194803049
Provider Name
Jac W. Pedersen Ii, D.d.s., Inc
Credential
Provider Entity Type
Organization
Address
620 California Blvd Ste H, San Luis Obispo, CA, 93401-2500
Phone Number
805-544-8111
Fax Number
805-544-6309
Provider Enumeration Date
11/01/2006
Last Update Date
03/08/2024
institution
Provider Business Practice Location Address Details
Address
620 California Blvd Ste H
City
San Luis Obispo
State
California
Zip
93401-2500
Phone Number
805-544-8111
Fax Number
805-544-6309
person
Provider Business Mailing Address Details
Address
620 California Blvd Ste H
City
San Luis Obispo
State
California
Zip
93401-2500
Phone Number
805-544-8111
Fax Number
805-544-6309
person
Provider's Taxonomy Details 1
Type
Dental Providers
Classification
Dentist
Speciality
Pediatric Dentistry
Taxonomy
1223P0221X
License No.
27472 (California)
Definition
An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs.
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