Organization
FUMIO SHIBATA DDS A PROFESSIONAL CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. FUMIO SHIBATA DDS (PRESIDENT)
(415) 608-7823
Entity
Organization
Contact information
Practice address
2200 LARKSPUR LANDING CIRCLE, SUITE 103, LARKSPUR, CA 94939
(415) 608-7823
Mailing address
PO BOX 4447, SAN RAFAEL, CA 94913-4447
(415) 608-7823
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
—
—
Other
Enumeration date
03/06/2007
Last updated
08/22/2020
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