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Organization
FILLMORE DENTAL SPA
Active
Organization
FILLMORE DENTAL SPA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CECILA SANTOS-BERKOWITZ D.M.D. (OWNER)
(415) 614-9850
Entity
Organization
Contact information
Practice address
3220 FILLMORE ST, SAN FRANCISCO, CA 94123-3403
(415) 614-9850
(415) 614-9881
Mailing address
3220 FILLMORE ST, SAN FRANCISCO, CA 94123-3403
(415) 614-9850
(415) 614-9881
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
43656
CA
1223P0300X
Periodontics
43590
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
43656
GENERAL DENTIST
CA
01
—
53490
PERIODONTIST
CA
Enumeration date
07/25/2007
Last updated
07/25/2007
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