| Birch Dental Group | |
|
155 Birch St Suite 5 Redwood City CA 94062-1340 | |
| (650) 366-0552 | |
| (650) 366-0701 |
| Full Name | Birch Dental Group |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 155 Birch St, Redwood City, California |
| Authorized Official Name and Position | Clark L Fong, Dds (OWNER) |
| Authorized Official Contact | 6503660552 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Birch Dental Group 155 Birch St Suite 5 Redwood City CA 94062-1340 Ph: (650) 366-0552 | Birch Dental Group 155 Birch St Suite 5 Redwood City CA 94062-1340 Ph: (650) 366-0552 |
| NPI Number | 1508052382 |
|---|---|
| Provider Enumeration Date | 09/14/2007 |
| Last Update Date | 03/18/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508052382 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 40351 (California) | Primary |
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