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DR. DORA KOROS GAVROS D.D.S
>> Dentist >> Dental ProvidersRegistrant NPI Number: 1932320744
Individual Registrant:DR. DORA KOROS GAVROS D.D.S
Gender: F
Sole Proprietor
Gender: F
Sole Proprietor
Location and contact information for practice:
1550 TIBURON BLVD SUITE X BELVEDERE, CA 94920-2564 US
Tel: 415-435-3111 Fax: 415-435-3147
Tel: 415-435-3111 Fax: 415-435-3147
Contact information for business:
1550 TIBURON BLVD SUITE X BELVEDERE, CA 94920-2564 US
Tel: 415-435-3111 Fax: 415-435-3147
Tel: 415-435-3111 Fax: 415-435-3147
Registration Information:
NPI: 1932320744
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 122300000X | Dental Providers Dentist | CA | 44720 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
| TAX ID NUMBER | 8820543714 | CA | 01 |
