| Mt. Tam Pediatric Dentistry | |
|
770 Tamalpais Dr Ste 317 Corte Madera CA 94925-1737 | |
| (775) 303-2282 | |
| Not Available |
| Full Name | Mt. Tam Pediatric Dentistry |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 770 Tamalpais Dr Ste 317, Corte Madera, California |
| Authorized Official Name and Position | Stephanie June Hardwick (PEDIATRIC DENTIST) |
| Authorized Official Contact | 4153296780 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mt. Tam Pediatric Dentistry 267 Corte Madera Ave Corte Madera CA 94925-1306 Ph: (775) 303-2282 | Mt. Tam Pediatric Dentistry 770 Tamalpais Dr Ste 317 Corte Madera CA 94925-1737 Ph: (775) 303-2282 |
| NPI Number | 1679164339 |
|---|---|
| Provider Enumeration Date | 01/26/2021 |
| Last Update Date | 07/12/2021 |
| Certification Date | 07/12/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679164339 | NPI | - | NPPES |
| 1881969517 | Other | CA | NPI TY1 |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | () | Primary |
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