Provider Demographics
NPI:1699979955
Name:LANDUCCI, ALBERT OJ (DDS)
Entity type:Individual
Prefix:DR
First Name:ALBERT
Middle Name:OJ
Last Name:LANDUCCI
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2720 EDISON ST
Mailing Address - Street 2:
Mailing Address - City:SAN MATEO
Mailing Address - State:CA
Mailing Address - Zip Code:94403-2458
Mailing Address - Country:US
Mailing Address - Phone:650-574-4444
Mailing Address - Fax:650-574-4441
Practice Address - Street 1:2720 EDISON ST
Practice Address - Street 2:
Practice Address - City:SAN MATEO
Practice Address - State:CA
Practice Address - Zip Code:94403-2458
Practice Address - Country:US
Practice Address - Phone:650-574-4444
Practice Address - Fax:650-574-4441
Is Sole Proprietor?:No
Enumeration Date:2007-06-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA202191223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics