Provider Demographics
NPI:1790509636
Name:MUIR ORAL FACIAL AND DENTAL IMPLANT SURGERY
Entity type:Organization
Organization Name:MUIR ORAL FACIAL AND DENTAL IMPLANT SURGERY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:NESTOR
Authorized Official - Middle Name:DENIS
Authorized Official - Last Name:KARAS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS MD
Authorized Official - Phone:925-933-6190
Mailing Address - Street 1:122 LA CASA VIA STE 223
Mailing Address - Street 2:
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94598-3014
Mailing Address - Country:US
Mailing Address - Phone:925-933-6190
Mailing Address - Fax:925-945-7320
Practice Address - Street 1:122 LA CASA VIA STE 223
Practice Address - Street 2:
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94598-3014
Practice Address - Country:US
Practice Address - Phone:925-933-6190
Practice Address - Fax:925-945-7320
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-07
Last Update Date:2024-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1942232541OtherORAL AND MAXILLOFACIAL SURGERY