| Nancy Derham Dental Corporation | |
|
1805 Novato Blvd #6 Novato CA 94947-2934 | |
| (415) 892-4721 | |
| (415) 892-5921 |
| Full Name | Nancy Derham Dental Corporation |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 1805 Novato Blvd, Novato, California |
| Authorized Official Name and Position | Nancy Derham (PRESIDENT) |
| Authorized Official Contact | 4158924721 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Nancy Derham Dental Corporation 1805 Novato Blvd #6 Novato CA 94947-2934 Ph: (415) 892-4721 | Nancy Derham Dental Corporation 1805 Novato Blvd #6 Novato CA 94947-2934 Ph: (415) 892-4721 |
| NPI Number | 1255502522 |
|---|---|
| Provider Enumeration Date | 03/14/2008 |
| Last Update Date | 03/14/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255502522 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 38914 (California) | Primary |
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