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2999 Regent St Suite #403 Berkeley CA 94705-2190 | |
| (510) 843-6341 | |
| (510) 845-5128 |
| Full Name | |
|---|---|
| Speciality | Dentist - Periodontics |
| Location | 2999 Regent St, Berkeley, California |
| Authorized Official Name and Position | Ryan Lawrence Horn (DENTIST) |
| Authorized Official Contact | 5108436341 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
2999 Regent St Suite #403 Berkeley CA 94705-2190 Ph: (510) 843-6341 | 2999 Regent St Suite #403 Berkeley CA 94705-2190 Ph: (510) 843-6341 |
| NPI Number | 1407150139 |
|---|---|
| Provider Enumeration Date | 01/10/2011 |
| Last Update Date | 01/10/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407150139 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0300X | Dentist - Periodontics | 56850 (California) | Primary |
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