| NPI | 1295131654 |
|---|---|
| Other Name | FACULTY DENTAL SERVICE GROUP |
| Entity Type | Organization |
| Authorized Contact | ED PEGUEROS Asst Dean, Budget & Fin Admin 415-351-7192 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 122300000X Dentist |
| Additional Taxonomies | 1223E0200X Dentist, Endodontics |
| 1223G0001X Dentist, General Practice | |
| 1223P0300X Dentist, Periodontics | |
| 1223P0700X Dentist, Prosthodontics | |
| Enumeration Date | 2014-11-13 |
| Last Update Date | 2020-07-22 |