Organization
TERRY PRATT D.D.S., INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KENNETH TERRY PRATT D.D.S. (OWNER DOCTOR)
(510) 522-7010
Entity
Organization
Contact information
Practice address
2217 CENTRAL AVE, ALAMEDA, CA 94501-4410
(510) 522-7010
(510) 522-2654
Mailing address
2217 CENTRAL AVE, ALAMEDA, CA 94501-4410
(510) 522-7010
(510) 522-2654
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
D20716
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
D20716
DENTAL LICENSE
CA
Enumeration date
04/13/2007
Last updated
08/22/2020
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