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Organization

L SWAYAMPRAKASAM DDS CORP

Active
Other names
SEASIDE PERIO CENTRE
Organization subpart
No

Provider details

NPI number
Authorized official
LOGESH SWAYAMPRAKASAM (PRESIDENT)
(224) 877-0645
Entity
Organization

Contact information

Practice address
1550 LOMBARD ST, SAN FRANCISCO, CA 94123-3154
(669) 245-7494
(669) 265-0400
Mailing address
3680 BEACON AVE APT B320, FREMONT, CA 94538-3033
(224) 877-0645

Taxonomy

Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
100140
CA

Other

Enumeration date
06/11/2018
Last updated
06/11/2018
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