Organization
P M KASROVI DDS MS A PROF DENTAL CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PAUL M KASROVI DDS MS (PRESIDENT)
(510) 204-8856
Entity
Organization
Contact information
Practice address
910 ENSENADA AVE, BERKELEY, CA 94705
(510) 204-8856
Mailing address
3010 COLBY ST, #220, BERKELEY, CA 94705
(510) 204-8856
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
40362
CA
Other
Enumeration date
05/15/2007
Last updated
08/22/2020
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