Maria Doreen Bautista | Daly City, CA • PECOS Search

Maria Doreen Bautista

Dentist

Dental Providers

980 King Drive #5, Daly City, CA 94015

PECOS Enrollment

Based on the most recent information from CMS, provider Maria Doreen Bautista does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records yesterday at 12:57 PM.

Profile Details

Provider ID
1942422563
Provider Type
Individual
Full Name
Bautista, Maria Doreen
Title
Dr.
Credential
DENTIST

Gender
Female
Sole Proprietor
No
Enumeration Date
5/3/2007
Last Updated
7/8/2007

Contact Information

Practice Location

980 King Drive #5, Daly City, CA 94015

(650) 878-1198

Mailing Location

980 King Drive #5, Daly City, CA 94015

(650) 878-1198

Provider Taxonomies

Code	Description	License
Code 1223G0001X Primary	Description Dentist Dental Providers	License CA47689 California