Berkeley Oral Surgery | |
2522 Dana St Suite 202 Berkeley CA 94704-2895 | |
(510) 848-1055 | |
(510) 848-1055 |
Full Name | Berkeley Oral Surgery |
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Speciality | Dentist - Oral And Maxillofacial Surgery |
Location | 2522 Dana St, Berkeley, California |
Authorized Official Name and Position | Craig Yale Bloom (PRESIDENT) |
Authorized Official Contact | 5108481055 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Berkeley Oral Surgery 2522 Dana St Suite 202 Berkeley CA 94704-2895 Ph: (510) 848-1055 | Berkeley Oral Surgery 2522 Dana St Suite 202 Berkeley CA 94704-2895 Ph: (510) 848-1055 |
NPI Number | 1194057174 |
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Provider Enumeration Date | 02/02/2010 |
Last Update Date | 02/02/2010 |
Identifier | Type | State | Issuer |
---|---|---|---|
1194057174 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1223S0112X | Dentist - Oral And Maxillofacial Surgery | 31571 (California) | Primary |
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