Healthcare Provider Details

I. General information

NPI: 1437818184
Provider Name (Legal Business Name): R. MICHAEL ALVAREZ, DDS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/09/2021
Last Update Date: 12/09/2021
Certification Date: 12/09/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 EL CERRO BLVD STE 105
DANVILLE CA
94526-1731
US

IV. Provider business mailing address

400 EL CERRO BLVD STE 105
DANVILLE CA
94526-1731
US

V. Phone/Fax

Practice location:
  • Phone: 925-837-8048
  • Fax: 925-837-8049
Mailing address:
  • Phone: 925-837-8048
  • Fax: 925-837-8049

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number
License Number State

VIII. Authorized Official

Name: AIMEE NASH
Title or Position: OFFICE MANAGER
Credential: RDA
Phone: 925-837-8048