Individual
BORIS LA NOIRE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
9130 ALCOSTA BLVD STE A, SAN RAMON, CA 94583-3847
(925) 230-9414
(925) 803-2568
Mailing address
4870 GENEVA AVE, CONCORD, CA 94521-2227
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
102327
CA
1223D0001X
Public Health Dentistry
102327
CA
Other
Enumeration date
03/16/2018
Last updated
04/30/2018
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