| Full Name | |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 2344 6th St, Berkeley, California |
| Authorized Official Name and Position | Martin Lynch (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 5109814123 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
Po Box 11247 Berkeley CA 94712-2247 Ph: (510) 981-4122 | 2344 6th St Berkeley CA 94710-2412 Ph: (510) 981-4122 |
| NPI Number | 1881082329 |
|---|---|
| Provider Enumeration Date | 01/07/2015 |
| Last Update Date | 01/07/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1881082329 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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