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3248 E Shields Ave Ste B Fresno CA 93726-6915 | |
(559) 225-8300 | |
Not Available |
Full Name | |
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Speciality | Clinic/Center |
Location | 3248 E Shields Ave Ste B, Fresno, California |
Authorized Official Name and Position | Leticia D Ramirez (VP, SECRETARY) |
Authorized Official Contact | 9512889319 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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3248 E Shields Ave Ste B Fresno CA 93726-6915 Ph: (559) 225-8300 | 3248 E Shields Ave Ste B Fresno CA 93726-6915 Ph: (559) 225-8300 |
NPI Number | 1679088652 |
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Provider Enumeration Date | 12/12/2017 |
Last Update Date | 09/22/2019 |
Medicare PECOS PAC ID | 3173988284 |
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Medicare Enrollment ID | O20230425000946 |
Identifier | Type | State | Issuer |
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1679088652 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QD0000X | Clinic/center - Dental | 101357 (California) | Primary |
Provider Name | Enrique Urruchi |
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Provider Type | Practitioner - Oral Surgery |
Provider Identifiers | NPI Number: 1720523004 PECOS PAC ID: 1658736772 Enrollment ID: I20230425001364 |
Raji Haddad D.d.s. Inc. Dba First Family Dental Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 310 W Shaw Ave, Fresno, CA 93704 Phone: 559-229-8200 | |
Kamal Dental Inc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 6319 N Fresno St Ste 101, Fresno, CA 93710 Phone: 559-438-6177 |