| South Shore Dental | |
|
2111 Whitehall Pl Ste C Alameda CA 94501-6160 | |
| (510) 523-5323 | |
| Not Available |
| Full Name | South Shore Dental |
|---|---|
| Speciality | Dentist |
| Location | 2111 Whitehall Pl Ste C, Alameda, California |
| Authorized Official Name and Position | Matthew Jin Lau (OWNER) |
| Authorized Official Contact | 5108468556 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| South Shore Dental 2111 Whitehall Pl Ste C Alameda CA 94501-6160 Ph: (510) 523-5323 | South Shore Dental 2111 Whitehall Pl Ste C Alameda CA 94501-6160 Ph: (510) 523-5323 |
| NPI Number | 1942695457 |
|---|---|
| Provider Enumeration Date | 04/01/2015 |
| Last Update Date | 04/01/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942695457 | NPI | - | NPPES |
| 1417282187 | Other | CA | INDIVIDUAL NPI |
| 58875 | Other | CA | DENTAL LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 58875 (California) | Primary |
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