| NPI | 1023145307 |
|---|---|
| Other Name | MAIN CLINIC |
| Entity Type | Organization |
| Authorized Contact | ED PEGUEROS Asst Dean, Budget & Fin Admin 415-351-7192 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 122300000X Dentist |
| Enumeration Date | 2007-02-27 |
| Last Update Date | 2020-07-22 |