Pacific Dental Group
NPI #1669802435 in San Rafael, California
Provider Information
- NPI Number
- 1669802435
- Entity Type
- Organization
- Organization Name
- Pacific Dental Group
- Primary Specialty
- Dentist - General Practice
- Enumeration Date
- Nov 15, 2013
- Last Updated
- Nov 15, 2013
Practice Location
- Address
- 1523 5TH AVE
- City
- San Rafael
- State
- California
- ZIP Code
- 94901-1806
- Phone
- (415) 453-6277
Authorized Official
- Name
- DR. CLARK FONG, DDS
- Title
- OWNER
- Phone
- (415) 453-6277
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist - General Practice — General Practice |
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