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Organization

BALLAN D TUCK DDS INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
BALLAN D TUCK DDS (SUPERVISING/MANAGING DENTIST)
(510) 251-1962
Entity
Organization

Contact information

Practice address
1375 GRAND AVE STE 101, PIEDMONT, CA 94610-1076
(510) 251-1962
(510) 251-8333
Mailing address
1375 GRAND AVE STE 101, PIEDMONT, CA 94610-1076
(510) 251-1962
(510) 251-8333

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary

Other

Enumeration date
08/12/2021
Last updated
05/19/2022
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