Healthcare Provider Details

I. General information

NPI: 1912201948
Provider Name (Legal Business Name): BELLA SHEN GARNETT, DMD, MMSC PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/05/2011
Last Update Date: 01/05/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

390 LAUREL ST SUITE 100
SAN FRANCISCO CA
94118-1980
US

IV. Provider business mailing address

390 LAUREL ST SUITE 100
SAN FRANCISCO CA
94118-1980
US

V. Phone/Fax

Practice location:
  • Phone: 415-292-2345
  • Fax: 415-292-0660
Mailing address:
  • Phone: 415-292-2345
  • Fax: 415-292-0660

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number48996
License Number StateCA

VIII. Authorized Official

Name: DR. BELLA S GARNETT
Title or Position: ORTHODONTIST
Credential: DMD, MMSC
Phone: 415-292-2345