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General NPI Number Information
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NPI Number | 1891815510
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Entity Type | Individual
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Provider Name | THOMAS A FACTOR DDS
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Gender | Male
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Dates
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Enumeration Date | 03/29/2007
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Last Update Date | 10/15/2021
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Provider Practice Location Address
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Address Line | 3100 19TH AVE
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City | SAN FRANCISCO
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State | CA
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Zip | 94132-2006
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Country | US
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Telephone | 415-584-2537
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Fax |
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Provider Business Mailing Address
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Address Line | 366 DOLAN AVE
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City | MILL VALLEY
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State | CA
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Zip | 94941-3824
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Country | US
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Telephone | 415-380-8959
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Fax | 415-584-0542
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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 | 1223E0200X
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Taxonomy Name | Endodontics
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License Number | 263408
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License Number State | CA
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