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General NPI Number Information
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NPI Number | 1700652674
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Entity Type | Individual
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Provider Name | ARIC LUCAS PEREZ DDS
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Gender | Male
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Dates
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Enumeration Date | 11/30/2023
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Last Update Date | 11/30/2023
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Provider Practice Location Address
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Address Line | 2720 24TH ST
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City | SAN FRANCISCO
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State | CA
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Zip | 94110-4212
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Country | US
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Telephone | 141-528-2456
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 590671
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City | SAN FRANCISCO
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State | CA
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Zip | 94159-0671
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Country | US
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Telephone | 909-659-9742
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 109399
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License Number State | CA
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