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General NPI Number Information
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NPI Number | 1265617948
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Entity Type | Organization
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Legal Business Name | IVAN A. SERDAR, DMD, INC.
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Dates
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Enumeration Date | 12/31/2007
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Last Update Date | 12/31/2007
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Provider Practice Location Address
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Address Line | 260 STOCKTON ST FLOOR 2
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City | SAN FRANCISCO
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State | CA
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Zip | 94108-5305
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Country | US
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Telephone | 415-397-1030
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Fax | 415-397-1032
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Provider Business Mailing Address
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Address Line | 260 STOCKTON ST FLOOR 2
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City | SAN FRANCISCO
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State | CA
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Zip | 94108-5305
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Country | US
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Telephone | 415-397-1030
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Fax | 415-397-1032
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. IVAN ADRIAN SERDAR
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Credential | D.M.D
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Telephone | 415-397-1030
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 45187
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License Number State | CA
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