Individual
JEFF TAKAI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
882 PRESIDIO AVE, SAN FRANCISCO, CA 94115-2921
(949) 244-6481
Mailing address
882 PRESIDIO AVE, SAN FRANCISCO, CA 94115-2921
(949) 244-6481
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
59877
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
59877
DENTAL BOARD OF CALIFORNIA
CA
Enumeration date
06/27/2012
Last updated
06/14/2013
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