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Organization
NANCY DERHAM DENTAL CORPORATION
Active
Organization
NANCY DERHAM DENTAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NANCY DERHAM DDS (PRESIDENT)
(415) 892-4721
Entity
Organization
Contact information
Practice address
1805 NOVATO BLVD, #6, NOVATO, CA 94947-2934
(415) 892-4721
(415) 892-5921
Mailing address
1805 NOVATO BLVD, #6, NOVATO, CA 94947-2934
(415) 892-4721
(415) 892-5921
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
38914
CA
Other
Enumeration date
03/14/2008
Last updated
03/14/2008
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