Organization
UCSF SCHOOL OF DENTISTRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARK RYDER DDS, MS (PROGRAM DIRECTOR)
(415) 476-1699
Entity
Organization
Contact information
Practice address
707 PARNASSUS AVE, BOX 0762, SAN FRANCISCO, CA 94143-0762
(415) 476-1731
Mailing address
707 PARNASSUS AVE, BOX 0762, SAN FRANCISCO, CA 94143-0762
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
64230
CA
Other
Enumeration date
02/24/2015
Last updated
02/24/2015
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