| Uniform | |
|
999 Sutter St Ste 102 San Francisco CA 94109-6023 | |
| (831) 238-7285 | |
| Not Available |
| Full Name | Uniform |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 999 Sutter St Ste 102, San Francisco, California |
| Authorized Official Name and Position | Kjeld A Aamodt (CHIEF MEDICAL OFFICER) |
| Authorized Official Contact | 8312387285 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Uniform 548 Market St # 36184 San Francisco CA 94104-5401 Ph: (831) 238-7285 | Uniform 999 Sutter St Ste 102 San Francisco CA 94109-6023 Ph: (831) 238-7285 |
| NPI Number | 1598267312 |
|---|---|
| Provider Enumeration Date | 03/07/2018 |
| Last Update Date | 03/07/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598267312 | NPI | - | NPPES |
| 1609391820 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 64545 (California) | Primary |
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