Provider Demographics
NPI:1386896686
Name:KALINCSAK, OMAR CHRISTIAN (DDS)
Entity type:Individual
Prefix:
First Name:OMAR
Middle Name:CHRISTIAN
Last Name:KALINCSAK
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2395 PACIFIC AVE
Mailing Address - Street 2:#105
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94115-1278
Mailing Address - Country:US
Mailing Address - Phone:310-895-5707
Mailing Address - Fax:
Practice Address - Street 1:2395 PACIFIC AVE
Practice Address - Street 2:#105
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94115-1278
Practice Address - Country:US
Practice Address - Phone:310-895-5707
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-10-17
Last Update Date:2012-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA574891223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice