| Seaside Perio Centre | |
|
1550 Lombard St San Francisco CA 94123-3154 | |
| (669) 245-7494 | |
| (669) 265-0400 |
| Full Name | Seaside Perio Centre |
|---|---|
| Speciality | Dentist - Periodontics |
| Location | 1550 Lombard St, San Francisco, California |
| Authorized Official Name and Position | Logesh Swayamprakasam (PRESIDENT) |
| Authorized Official Contact | 2248770645 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Seaside Perio Centre 3680 Beacon Ave Apt B320 Fremont CA 94538-3033 Ph: (224) 877-0645 | Seaside Perio Centre 1550 Lombard St San Francisco CA 94123-3154 Ph: (669) 245-7494 |
| NPI Number | 1508359902 |
|---|---|
| Provider Enumeration Date | 06/11/2018 |
| Last Update Date | 06/11/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508359902 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0300X | Dentist - Periodontics | 100140 (California) | Primary |
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