Provider Demographics
NPI:1740884691
Name:CLINT K TAURA DDS PC
Entity type:Organization
Organization Name:CLINT K TAURA DDS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:CLINT
Authorized Official - Middle Name:KOHICHIRO
Authorized Official - Last Name:TAURA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:415-563-2000
Mailing Address - Street 1:1788 SUTTER ST STE 201
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94115-3218
Mailing Address - Country:US
Mailing Address - Phone:415-563-2000
Mailing Address - Fax:
Practice Address - Street 1:1788 SUTTER ST STE 201
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94115-3218
Practice Address - Country:US
Practice Address - Phone:415-563-2000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-22
Last Update Date:2020-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental