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Organization
PINOLE ORAL SURGERY
Active
Organization
PINOLE ORAL SURGERY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NICOLE ANDRE (OFFICE MANAGER)
(510) 724-3922
Entity
Organization
Contact information
Practice address
2150 APPIAN WAY STE 201, PINOLE, CA 94564-2520
(510) 724-3922
(510) 724-1037
Mailing address
2150 APPIAN WAY STE 201, PINOLE, CA 94564-2520
(510) 724-3922
(510) 724-1037
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
46586
CA
Other
Enumeration date
08/07/2009
Last updated
05/14/2014
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