# C-DENTAL X-RAY, INC.

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

## Provider details

- **NPI number:** 1245606847
- **Authorized official:** MR. JEROME N PECK DLXT (CEO)
- **Authorized official phone:** (650) 207-6209

## Contact information

- **Practice address:** 362 W PORTAL AVE, SAN FRANCISCO, CA 94127-1412
- **Practice address phone:** (415) 753-8701
- **Mailing address:** 450 SUTTER ST, STE. 1542, SAN FRANCISCO, CA 94108-4206
- **Mailing address phone:** (415) 421-1389

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 292200000X | Dental Laboratory | RHP00053519 | CA | Yes |

## Other

- **Enumeration date:** 08/18/2015
- **Last updated:** 08/18/2015