Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0221X | Pediatric Dentist | 52163 | CA |
NPI | 1003960543 |
---|---|
Provider Name | Dr. Alfred Jeffrey Wood |
First Address | San Francisco, CA 94103-2919 |
Second Address | San Francisco, CA 94103-2919 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/01/2007 |
Last Update Date | 10/06/2014 |