Provider Demographics
NPI:1699183046
Name:STUDIO DENTAL INC
Entity Type:Organization
Organization Name:STUDIO DENTAL INC
Other - Org Name:STUDIO DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LOWELL
Authorized Official - Middle Name:
Authorized Official - Last Name:CAULDER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:415-527-0263
Mailing Address - Street 1:455 MISSION BAY BLVD S
Mailing Address - Street 2:SUITE 124
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94158-2158
Mailing Address - Country:US
Mailing Address - Phone:415-515-0450
Mailing Address - Fax:
Practice Address - Street 1:455 MISSION BAY BLVD S
Practice Address - Street 2:SUITE 124
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94158-2158
Practice Address - Country:US
Practice Address - Phone:415-515-0450
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-30
Last Update Date:2014-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty