Provider First Line Business Practice Location Address:
4 EMBARCADERO CTR
Provider Second Line Business Practice Location Address:
LOBBY LEVEL / DENTAL OFFICE
Provider Business Practice Location Address City Name:
SAN FRANCISCO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
94111-5900
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
415-576-9800
Provider Business Practice Location Address Fax Number:
415-576-1345
Provider Enumeration Date:
08/17/2006