| Tamal Vista Family Dentistry | |
|
1447 4th St San Rafael CA 94901-2811 | |
| (415) 453-4720 | |
| (415) 453-4727 |
| Full Name | Tamal Vista Family Dentistry |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 1447 4th St, San Rafael, California |
| Authorized Official Name and Position | Daniel Eric Scott (OWNER) |
| Authorized Official Contact | 4154534720 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Tamal Vista Family Dentistry 1447 4th St San Rafael CA 94901-2811 Ph: (415) 453-4720 | Tamal Vista Family Dentistry 1447 4th St San Rafael CA 94901-2811 Ph: (415) 453-4720 |
| NPI Number | 1154999134 |
|---|---|
| Provider Enumeration Date | 06/15/2021 |
| Last Update Date | 06/15/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154999134 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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