Healthcare Provider Details

I. General information

NPI: 1790731131
Provider Name (Legal Business Name): RICHARD F BRONSON DDS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/26/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2001 UNION ST SUITE 280
SAN FRANCISCO CA
94123-4141
US

IV. Provider business mailing address

2001 UNION ST SUITE 280
SAN FRANCISCO CA
94123-4141
US

V. Phone/Fax

Practice location:
  • Phone: 415-921-4090
  • Fax:
Mailing address:
  • Phone: 415-921-4090
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223E0200X
TaxonomyEndodontics
License Number23169
License Number StateCA

VIII. Authorized Official

Name: CAROL J BRONSON
Title or Position: MANAGER
Credential:
Phone: 415-921-4090