# EDMOND DE ST GEORGES DDS INC

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

## Provider details

- **NPI number:** 1649356098
- **Authorized official:** DR. EDMOND DE ST GEORGES DDS (DENTIST CEO)
- **Authorized official phone:** (408) 263-1255

## Contact information

- **Practice address:** 452 E CALAVERAS BLVD, MILPITAS, CA 95035-5412
- **Practice address phone:** (408) 263-1255
- **Practice address fax:** (408) 263-5167
- **Mailing address:** 452 E CALAVERAS BLVD, MILPITAS, CA 95035-5412
- **Mailing address phone:** (408) 263-1255
- **Mailing address fax:** (408) 263-5167

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 19493 | CA | Yes |

## Other

- **Enumeration date:** 10/28/2006
- **Last updated:** 04/05/2012