M Elder D D S A Professional Corporation
Dentist, Oral and Maxillofacial Surgery in Pinole, CA. Organization (NPI-2).
NPI number1760633341
StatusActive
Last updated in NPPESAug 18, 2016
Details
- NPI
- 1760633341
- Entity type
- Organization (NPI-2)
- Legal business name
- M Elder D D S A Professional Corporation
- Organization subpart
- No
- Enumeration date
- Oct 1, 2008
- Last updated
- Aug 18, 2016
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1223S0112X | Dentist, Oral and Maxillofacial Surgery | 46586 | CA | Yes |
Practice location
2150 Appian Way Ste 201Pinole Oral Surgery
Pinole, CA 94564-2520
Phone 510-724-3922 · Fax 510-724-1037
Mailing address
140 Admiral Callaghan Lane Ste BVallejo, CA 94591
Phone 415-892-1190 · Fax 415-892-7355
Authorized official
Mahr Fairuke Elder
President / Ceo
4158921190
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Other Oral and Maxillofacial Surgery (Dentist) providers in Pinole, CA
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- Brady Kenneth Lyons, DMDNPI 1730256702
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All 6 Oral and Maxillofacial Surgery (Dentist) providers in Pinole · All 499 providers in Pinole
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