Individual provider · Type 1 NPI

Mark Charles Fagan, DDS

Periodontics · San Jose, CA

NPI number 1376562827 Active

Practice location

1660 Willow St, Ste #3
San Jose, CA 95125-5101

Call (408) 269-1060 Map

Specialties and licenses

TaxonomyCodeLicense
Periodontics Primary 1223P0300X38419 (CA)

Periodontics: That specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structures and tissues.

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About NPI 1376562827

Mark Charles Fagan, DDS's National Provider Identifier is 1376562827, issued on Jul 18, 2006. The primary taxonomy on file is Periodontics (1223P0300X), and the practice location is in San Jose, CA. The record was last updated on Jul 8, 2007.