Ian Iwane DDS

NPI #1962817882 in Berkeley, California

Provider Information

NPI Number: 1962817882
Entity Type: Organization
Organization Name: Ian Iwane DDS
Primary Specialty: Dentist
Enumeration Date: Jun 30, 2014
Last Updated: Jun 30, 2014

Practice Location

Address: 1536 BLAKE ST
Address 2: NONE
City: Berkeley
State: California
ZIP Code: 94703-1806
Phone: (415) 845-0217

Authorized Official

Name: IAN MICHIO IWANE, DDS
Title: OWNER
Phone: (415) 845-0217

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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