Organization
MCCORMACK DENTAL IMAGING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JEROME N. PECK DLXT (CEO)
(415) 421-1389
Entity
Organization
Contact information
Practice address
1550 HOTEL CIR N, STE. 340, SAN DIEGO, CA 92108-2901
(619) 296-6132
Mailing address
450 SUTTER ST, SUITE 1542, SAN FRANCISCO, CA 94108-4206
(415) 421-1389
Taxonomy
Speciality
Code
Description
License number
State
292200000X
Dental Laboratory
Primary
RHP00053519
CA
Other
Enumeration date
10/15/2015
Last updated
10/15/2015
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