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1497112338
THEODORE ROBERT SMALL
BERKELEY, CA
NPI
1497112338
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
122300000X Dentist
(Licence: UT 140487-9922)
Enumeration Date
2016-01-22
Last Update Date
2016-01-22
Business Address
-- THEODORE ROBERT SMALL DDS
1301 BONITA AVE APT 4
BERKELEY, CA 94709-1983
Phone number: 510-559-9097
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Mailing Address
-- THEODORE ROBERT SMALL DDS
1301 BONITA AVE APT 4
BERKELEY, CA 94709-1983
Phone number: 510-559-9097
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