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6767 N Fresno St Suite 200 Fresno CA 93710-3709 | |
| (559) 447-3020 | |
| (559) 447-3025 |
| Full Name | |
|---|---|
| Speciality | Dentist |
| Location | 6767 N Fresno St, Fresno, California |
| Authorized Official Name and Position | Thomas Lee Winegarden (OWNER) |
| Authorized Official Contact | 5594473020 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
6767 N Fresno St Suite 200 Fresno CA 93710-3709 Ph: (559) 447-3020 | 6767 N Fresno St Suite 200 Fresno CA 93710-3709 Ph: (559) 447-3020 |
| NPI Number | 1861675597 |
|---|---|
| Provider Enumeration Date | 12/17/2007 |
| Last Update Date | 06/30/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861675597 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 29905 (California) | Primary |
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