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General NPI Number Information
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NPI Number | 1467235796
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Entity Type | Organization
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Legal Business Name | NOE VALLEY SMILES AND BRACES
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Dates
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Enumeration Date | 08/18/2023
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Last Update Date | 08/18/2023
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Provider Practice Location Address
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Address Line | 3932 24TH ST
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City | SAN FRANCISCO
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State | CA
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Zip | 94114-3704
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Country | US
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Telephone | 415-678-5445
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Fax |
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Provider Business Mailing Address
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Address Line | 3932 24TH ST
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City | SAN FRANCISCO
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State | CA
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Zip | 94114-3704
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | DR. SIAMAK JAFARI
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Credential | DMD
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Telephone | 925-542-0449
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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 |
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License Number State |
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