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General NPI Number Information
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NPI Number | 1093414609
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Entity Type | Organization
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Legal Business Name | R. MICHAEL ALVAREZ, DDS, INC.
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Dates
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Enumeration Date | 03/02/2023
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Last Update Date | 03/02/2023
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Provider Practice Location Address
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Address Line | 2188 PERALTA BLVD STE D
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City | FREMONT
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State | CA
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Zip | 94536-3941
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Country | US
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Telephone | 510-713-6790
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Fax | 510-713-6794
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Provider Business Mailing Address
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Address Line | 2188 PERALTA BLVD STE D
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City | FREMONT
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State | CA
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Zip | 94536-3941
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Country | US
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Telephone | 510-713-6790
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Fax | 510-713-6794
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | LOLA NIETO
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Credential |
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Telephone | 510-713-6790
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X2210X
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Taxonomy Name | Orofacial Pain Dentistry
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number |
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License Number State |
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