| Dental Medicine Providers | |
|
1050 Northgate Dr 250b San Rafael CA 94903-2526 | |
| (415) 306-1456 | |
| Not Available |
| Full Name | Dental Medicine Providers |
|---|---|
| Speciality | Dentist |
| Location | 1050 Northgate Dr, San Rafael, California |
| Authorized Official Name and Position | Christine Campbell (OFFICE ADMINISTRATOR) |
| Authorized Official Contact | 9167376453 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dental Medicine Providers 1050 Northgate Dr 250b San Rafael CA 94903-2526 Ph: (415) 306-1456 | Dental Medicine Providers 1050 Northgate Dr 250b San Rafael CA 94903-2526 Ph: (415) 306-1456 |
| NPI Number | 1205129624 |
|---|---|
| Provider Enumeration Date | 05/18/2011 |
| Last Update Date | 05/18/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205129624 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 45975 (California) | Primary |
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