Provider Demographics
NPI:1568622553
Name:DAVID W. EPSTEIN DDS INC
Entity Type:Organization
Organization Name:DAVID W. EPSTEIN DDS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:WILLIAM
Authorized Official - Last Name:EPSTEIN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:415-897-6453
Mailing Address - Street 1:1701 NOVATO BLVD
Mailing Address - Street 2:SUITE 306
Mailing Address - City:NOVATO
Mailing Address - State:CA
Mailing Address - Zip Code:94947-3000
Mailing Address - Country:US
Mailing Address - Phone:415-897-6453
Mailing Address - Fax:415-898-1013
Practice Address - Street 1:1701 NOVATO BLVD
Practice Address - Street 2:SUITE 306
Practice Address - City:NOVATO
Practice Address - State:CA
Practice Address - Zip Code:94947-3000
Practice Address - Country:US
Practice Address - Phone:415-897-6453
Practice Address - Fax:415-898-1013
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-12
Last Update Date:2008-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA44675261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental