| Lifelong Dental Care | |
|
1860 Alcatraz Ave Berkeley CA 94703-2715 | |
| (510) 653-8500 | |
| Not Available |
| Full Name | Lifelong Dental Care |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 1860 Alcatraz Ave, Berkeley, California |
| Authorized Official Name and Position | Marty Lynch (CEO) |
| Authorized Official Contact | 5109814100 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lifelong Dental Care Po Box 11247 Berkeley CA 94712-2247 Ph: (510) 981-4100 | Lifelong Dental Care 1860 Alcatraz Ave Berkeley CA 94703-2715 Ph: (510) 653-8500 |
| NPI Number | 1013913300 |
|---|---|
| Provider Enumeration Date | 06/22/2005 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013913300 | NPI | - | NPPES |
| FHC70239F | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (California) | Primary |
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