# UCSF FACULTY GROUP DENTAL PRACTICE

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1073693057
- **Authorized official:** DR. CHARLES BERTOLAMI DDS (DEAN, SCHOOL OF DENTISTRY)
- **Authorized official phone:** (415) 476-1323

## Contact information

- **Practice address:** 707 PARNASSUS AVE, SUITE D4000, SAN FRANCISCO, CA 94143-2210
- **Practice address phone:** (415) 476-3028
- **Practice address fax:** (415) 502-8399
- **Mailing address:** 707 PARNASSUS AVE, SUITE D4000, SAN FRANCISCO, CA 94143-2210
- **Mailing address phone:** (415) 476-3028
- **Mailing address fax:** (415) 502-8399

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223E0200X | Endodontics | — | — | — |
| 1223G0001X | General Practice Dentistry | — | — | — |
| 1223P0700X | Prosthodontics | — | — | Yes |

## Other

- **Enumeration date:** 10/16/2006
- **Last updated:** 09/11/2025

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 2065 | DELTA DENTAL | CA |