Individual
DR. DORA KOROS GAVROS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.D.S
Contact information
Practice address
1550 TIBURON BLVD, SUITE X, BELVEDERE, CA 94920-2564
(415) 435-3111
(415) 435-3147
Mailing address
1550 TIBURON BLVD, SUITE X, BELVEDERE, CA 94920-2564
(415) 435-3111
(415) 435-3147
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
44720
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
8820543714
TAX ID NUMBER
CA
Enumeration date
05/01/2007
Last updated
07/08/2007
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