Healthcare Provider Details

I. General information

NPI: 1942232541
Provider Name (Legal Business Name): NESTOR KARAS DDS MD INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/06/2006
Last Update Date: 02/15/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1800 SAN MIGUEL DR
WALNUT CREEK CA
94596-8606
US

IV. Provider business mailing address

1800 SAN MIGUEL DR
WALNUT CREEK CA
94596-8606
US

V. Phone/Fax

Practice location:
  • Phone: 925-933-6190
  • Fax: 925-945-7320
Mailing address:
  • Phone: 925-933-6190
  • Fax: 925-945-7320

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QS0112X
TaxonomyOral and Maxillofacial Surgery Clinic/Center
License Number35742
License Number StateCA

VIII. Authorized Official

Name: DR. NESTOR DENIS KARAS
Title or Position: CEO
Credential: DDS, MD
Phone: 925-933-6190