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2001 Union St Ste 280 San Francisco CA 94123-4107 | |
| (415) 931-3100 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Clinic/center - Oral And Maxillofacial Surgery |
| Location | 2001 Union St Ste 280, San Francisco, California |
| Authorized Official Name and Position | Dennis Song (CEO) |
| Authorized Official Contact | 4159313100 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
2001 Union St Ste 280 San Francisco CA 94123-4107 Ph: (415) 931-3100 | 2001 Union St Ste 280 San Francisco CA 94123-4107 Ph: (415) 931-3100 |
| NPI Number | 1295244119 |
|---|---|
| Provider Enumeration Date | 09/22/2017 |
| Last Update Date | 07/21/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295244119 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Secondary |
| 261QS0112X | Clinic/center - Oral And Maxillofacial Surgery | (* (Not Available)) | Primary |
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