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683 Folsom Street San Francisco CA 94107 | |
| (415) 777-3337 | |
| (415) 777-3338 |
| Full Name | |
|---|---|
| Speciality | Dentist |
| Location | 683 Folsom Street, San Francisco, California |
| Authorized Official Name and Position | Oliver M Fernandez (PRESIDENT OF CORPORATION) |
| Authorized Official Contact | 4157773337 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
683 Folsom Street San Francisco CA 94107 Ph: (415) 777-3337 | 683 Folsom Street San Francisco CA 94107 Ph: (415) 777-3337 |
| NPI Number | 1578670782 |
|---|---|
| Provider Enumeration Date | 08/24/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578670782 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 45688 (California) | Primary |
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