Healthcare Provider Details

I. General information

NPI: 1801809017
Provider Name (Legal Business Name): TOM ALAN JOW DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/15/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

450 SUTTER ST #2525
SAN FRANCISCO CA
94108-4204
US

IV. Provider business mailing address

450 SUTTER ST #2525
SAN FRANCISCO CA
94108-4204
US

V. Phone/Fax

Practice location:
  • Phone: 415-392-5300
  • Fax: 415-392-2538
Mailing address:
  • Phone: 415-392-5300
  • Fax: 415-392-2538

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0700X
TaxonomyProsthodontics
License Number31483
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: