Provider Demographics
NPI:1205556933
Name:BAYSAC DENTAL HEALTH 3580 CALIFORNIA, PC
Entity type:Organization
Organization Name:BAYSAC DENTAL HEALTH 3580 CALIFORNIA, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
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:415-518-6425
Mailing Address - Street 1:3501 CALIFORNIA ST STE 201
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94118-1743
Mailing Address - Country:US
Mailing Address - Phone:415-563-2022
Mailing Address - Fax:844-863-1211
Practice Address - Street 1:3501 CALIFORNIA ST STE 201
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94118-1743
Practice Address - Country:US
Practice Address - Phone:415-563-2022
Practice Address - Fax:844-863-1211
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-01
Last Update Date:2022-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental