Provider Demographics
NPI:1528179579
Name:CALANDRI, GEORGE EUGENE (DDS)
Entity Type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:EUGENE
Last Name:CALANDRI
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:136 KEIL BAY
Mailing Address - Street 2:
Mailing Address - City:ALAMEDA
Mailing Address - State:CA
Mailing Address - Zip Code:94502-7922
Mailing Address - Country:US
Mailing Address - Phone:510-865-6625
Mailing Address - Fax:510-865-1179
Practice Address - Street 1:2215 SANTA CLARA AVE
Practice Address - Street 2:
Practice Address - City:ALAMEDA
Practice Address - State:CA
Practice Address - Zip Code:94501-4416
Practice Address - Country:US
Practice Address - Phone:510-865-6625
Practice Address - Fax:510-865-1179
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA317591223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice