| Select Dental | |
|
1050 Northgate Dr Ste 505 San Rafael CA 94903-2542 | |
| (415) 499-9300 | |
| Not Available |
| Full Name | Select Dental |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 1050 Northgate Dr Ste 505, San Rafael, California |
| Authorized Official Name and Position | Alireza Mola (OWNER/PRESIDENT) |
| Authorized Official Contact | 5105907297 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Select Dental 145 E 14th St # 100 San Leandro CA 94577-1661 Ph: (510) 587-9400 | Select Dental 1050 Northgate Dr Ste 505 San Rafael CA 94903-2542 Ph: (415) 499-9300 |
| NPI Number | 1043791890 |
|---|---|
| Provider Enumeration Date | 08/28/2018 |
| Last Update Date | 09/20/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043791890 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 62246 (California) | Primary |
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