Healthcare Provider Details

I. General information

NPI: 1205556933
Provider Name (Legal Business Name): BAYSAC DENTAL HEALTH 3580 CALIFORNIA, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/01/2022
Last Update Date: 09/01/2022
Certification Date: 09/01/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3501 CALIFORNIA ST STE 201
SAN FRANCISCO CA
94118-1743
US

IV. Provider business mailing address

3501 CALIFORNIA ST STE 201
SAN FRANCISCO CA
94118-1743
US

V. Phone/Fax

Practice location:
  • Phone: 415-563-2022
  • Fax: 844-863-1211
Mailing address:
  • Phone: 415-563-2022
  • Fax: 844-863-1211

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. MARY ANNE BAYSAC
Title or Position: OWNER
Credential: D.D.S.
Phone: 415-518-6425