Provider Demographics
NPI:1467187583
Name:BAYSAC DENTAL GROUP SAN FRANCISCO 133 KEARNY PC
Entity Type:Organization
Organization Name:BAYSAC DENTAL GROUP SAN FRANCISCO 133 KEARNY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MARY ANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:BAYSAC
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:415-989-3648
Mailing Address - Street 1:133 KEARNY ST STE 301
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94108-4811
Mailing Address - Country:US
Mailing Address - Phone:415-989-3648
Mailing Address - Fax:415-989-3648
Practice Address - Street 1:133 KEARNY ST STE 301
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94108-4811
Practice Address - Country:US
Practice Address - Phone:415-989-3648
Practice Address - Fax:415-989-3648
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-21
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental