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General NPI Number Information
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NPI Number | 1093880353
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Entity Type | Organization
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Legal Business Name | UCSF DIVISION OF ORTHODONTICS
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Dates
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Enumeration Date | 11/22/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 707 PARNASSUS AVE BOX 0438
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City | SAN FRANCISCO
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State | CA
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Zip | 94143-0438
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Country | US
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Telephone | 415-502-6707
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Fax | 415-514-0377
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Provider Business Mailing Address
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Address Line | 707 PARNASSUS AVE BOX 0438
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City | SAN FRANCISCO
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State | CA
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Zip | 94143-0438
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Country | US
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Telephone | 415-502-6707
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Fax | 415-514-0377
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Authorized Official
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Title or Position | DEAN SCHOOL OF DENTISTRY
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Name | DR. CHARLES N BERTOLAMI
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Credential |
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Telephone | 415-476-1323
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number |
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License Number State |
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