Organization
MAHR ELDER DDS MD P C
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MAHR FAIRUKE ELDER DDS, MD (PRESIDENT)
(415) 892-1190
Entity
Organization
Contact information
Practice address
1805 NOVATO BLVD, SUITE 1, NOVATO, CA 94947-2934
(415) 892-1190
(415) 892-7355
Mailing address
1805 NOVATO BLVD, SUITE 1, NOVATO, CA 94947-2934
(415) 892-1190
(415) 892-7355
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
D46586
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
G93803-01
MEDI-CAL
CA
Enumeration date
08/07/2007
Last updated
08/10/2016
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