1012 Group, Inc

General Practice Dentistry · San Mateo, CA

Organization Active NPI

NPI number 1730535774

Practice location

800 S B St
Suite #200
San Mateo, CA 94401-4271
Phone
(650) 458-3727

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NPI record

NPI
1730535774
Entity type
Organization (Type 2)
Enumeration date
May 9, 2016
Last updated
May 9, 2016
Organization subpart
No

Specialties & taxonomy codes

TaxonomyCodeLicenseState
General Practice Dentistry Primary 1223G0001X 58767 CA

Authorized official

Name
Patti Bolander
Title
Director of Operations
Phone
(650) 458-3727

Other names

  • Bloom Dental Group

About 1012 Group, Inc

1012 Group, Inc is a healthcare organization registered in the NPI registry with the primary taxonomy General Practice Dentistry (code 1223G0001X). The practice location is 800 S B St, Suite #200, San Mateo, CA 94401-4271. The NPI number 1730535774 was assigned on May 9, 2016 and the record was last updated on May 9, 2016.

1012 Group, Inc lists a license in the registry: #58767 (CA) for General Practice Dentistry. License numbers are self-reported to NPPES; verify them with the state licensing board.

The authorized official for this organization is Patti Bolander, Director of Operations.

Frequently asked questions

What is the NPI number of 1012 Group, Inc?

The NPI number is 1730535774.

What is the phone number of 1012 Group, Inc?

The phone number listed for the practice location is (650) 458-3727.

Where is 1012 Group, Inc located?

800 S B St, Suite #200, San Mateo, CA 94401-4271.

What is the taxonomy code for 1012 Group, Inc?

The primary taxonomy code is 1223G0001X – General Practice Dentistry.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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