Provider Demographics
NPI:1710478458
Name:ENGLISH DENTAL CORPORATION
Entity Type:Organization
Organization Name:ENGLISH DENTAL CORPORATION
Other - Org Name:BAY AREA MINI DENTAL IMPLANT CENTERS OF AMERICA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:C.E.O.
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:L
Authorized Official - Last Name:ENGLISH
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:650-737-7907
Mailing Address - Street 1:2400 WESTBOROUGH BLVD.
Mailing Address - Street 2:SUITE 105
Mailing Address - City:SOUTH SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94080
Mailing Address - Country:US
Mailing Address - Phone:650-737-7907
Mailing Address - Fax:650-737-7906
Practice Address - Street 1:2400 WESTBOROUGH BLVD.
Practice Address - Street 2:SUITE 105
Practice Address - City:SOUTH SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94080
Practice Address - Country:US
Practice Address - Phone:833-468-6464
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-29
Last Update Date:2018-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA388371223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty