| Fumio Shibata Dds A Professional Corp | |
|
2200 Larkspur Landing Circle Suite 103 Larkspur CA 94939 | |
| (415) 608-7823 | |
| Not Available |
| Full Name | Fumio Shibata Dds A Professional Corp |
|---|---|
| Speciality | Dentist - Periodontics |
| Location | 2200 Larkspur Landing Circle, Larkspur, California |
| Authorized Official Name and Position | Fumio Shibata (PRESIDENT) |
| Authorized Official Contact | 4156087823 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Fumio Shibata Dds A Professional Corp Po Box 4447 San Rafael CA 94913-4447 Ph: (415) 608-7823 | Fumio Shibata Dds A Professional Corp 2200 Larkspur Landing Circle Suite 103 Larkspur CA 94939 Ph: (415) 608-7823 |
| NPI Number | 1447380928 |
|---|---|
| Provider Enumeration Date | 03/06/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1447380928 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0300X | Dentist - Periodontics | (* (Not Available)) | Primary |
Simple Orthodontics Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 265 Magnolia Ave, Ste 100, Larkspur, CA 94939 Phone: 415-746-1300 | |
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