# PROSTHETIC DENTISTRY

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

## Provider details

- **NPI number:** 1306975073
- **Authorized official:** GALEN WAGNILD (PARTNER)
- **Authorized official phone:** (415) 956-5162

## Contact information

- **Practice address:** 450 SUTTER ST, SUITE 1636, SAN FRANCISCO, CA 94108-4206
- **Practice address phone:** (415) 956-5162
- **Practice address fax:** (415) 956-0166
- **Mailing address:** 450 SUTTER ST, SUITE 1636, SAN FRANCISCO, CA 94108-4206
- **Mailing address phone:** (415) 956-5162
- **Mailing address fax:** (415) 956-0166

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223P0700X | Prosthodontics | — | NULL | Yes |
| 1223P0700X | Prosthodontics | — | — | Yes |

## Other

- **Enumeration date:** 03/05/2007
- **Last updated:** 04/11/2012