Organization
PROSTHETIC DENTISTRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GALEN WAGNILD (PARTNER)
(415) 956-5162
Entity
Organization
Contact information
Practice address
450 SUTTER ST, SUITE 1636, SAN FRANCISCO, CA 94108-4206
(415) 956-5162
(415) 956-0166
Mailing address
450 SUTTER ST, SUITE 1636, SAN FRANCISCO, CA 94108-4206
(415) 956-5162
(415) 956-0166
Taxonomy
Speciality
Code
Description
License number
State
1223P0700X
Prosthodontics
Primary
—
—
Other
Enumeration date
03/05/2007
Last updated
04/11/2012
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