Organization
AMIRI AND LUQUE DENTAL CORP
Active
Other names
Oakland Dental Specialty Center, Oakland Dental Specialty Center
Organization subpart
No
Provider details
NPI number
Authorized official
SUZANNE NIEMIEC (OFFICE MANAGER)
(510) 256-7116
Entity
Organization
Contact information
Practice address
8105 EDGEWATER DR STE 1, OAKLAND, CA 94621-2019
(510) 256-7116
Mailing address
8105 EDGEWATER DR STE 1, OAKLAND, CA 94621-2019
(510) 256-7116
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
—
—
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
61795
CA
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
—
261QD0000X
Dental Clinic/Center
102443
CA
261QD0000X
Dental Clinic/Center
54003
CA
Other
Enumeration date
06/29/2018
Last updated
06/29/2018
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