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Individual

SAID JALIL SADRI

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DMD

Contact information

Practice address
5939 LA SALLE AVE, OAKLAND, CA 94611-3225
(510) 292-1771
Mailing address
5939 LA SALLE AVE, OAKLAND, CA 94611-3225
(510) 292-1771

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
49985
CA
1223G0001X
General Practice Dentistry
49985
CA
1223P0700X
Prosthodontics
Primary
49985
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
D4603092
DRIVER LICENSE
CA
Enumeration date
03/23/2017
Last updated
03/23/2017
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