Organization
ORAL PATHOLOGY LABORATORY UCSF SCHOOL OF DENTISTRY
Active
Other names
UCSF ORAL PATHOLOGY LABORATORY
Organization subpart
No
Provider details
NPI number
Authorized official
RICHARD C.K. JORDAN DDS (PRESIDENT)
(415) 476-4868
Entity
Organization
Contact information
Practice address
513 PARNASSUS AVE, SAN FRANCISCO, CA 94143-2205
(415) 476-4868
Mailing address
PO BOX 10076, VAN NUYS, CA 91410-0076
(805) 578-8300
(805) 578-8950
Taxonomy
Speciality
Code
Description
License number
State
292200000X
Dental Laboratory
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
LAB41260F
—
CA
Enumeration date
04/04/2006
Last updated
11/16/2009
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