Organization
SOUTH BAY DENTAL PRACTICE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PATHMINI PATHMANABHAN (PRESIDENT)
(510) 573-1933
Entity
Organization
Contact information
Practice address
3200 MOWRY AVE STE B, FREMONT, CA 94538-1510
(510) 796-7600
Mailing address
3200 MOWRY AVE STE B, FREMONT, CA 94538-1510
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
11/02/2018
Last updated
11/02/2018
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