Organization
ELDER DENTAL CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MAHR ELDER DDS (OWNER)
(415) 890-1190
Entity
Organization
Contact information
Practice address
19 ROTARY WAY, VALLEJO, CA 94591-8475
(415) 890-1190
Mailing address
19 ROTARY WAY, VALLEJO, CA 94591-8475
(415) 890-1190
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
93771
CA
Other
Enumeration date
12/01/2016
Last updated
12/02/2016
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