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4120 Dale Rd Suite J-6 Modesto CA 95356-9232 | |
| (209) 247-3307 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 4120 Dale Rd, Modesto, California |
| Authorized Official Name and Position | Maulik M Shah (OWNER DENTIST/CEO) |
| Authorized Official Contact | 2092473307 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
4116 Dragoo Park Dr Modesto CA 95356-1860 Ph: (209) 247-3307 | 4120 Dale Rd Suite J-6 Modesto CA 95356-9232 Ph: (209) 247-3307 |
| NPI Number | 1508095068 |
|---|---|
| Provider Enumeration Date | 07/06/2009 |
| Last Update Date | 07/06/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508095068 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 50677 (California) | Primary |
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