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605 Standiford Ave Suite G Modesto CA 95350-1000 | |
| (209) 633-1200 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 605 Standiford Ave, Modesto, California |
| Authorized Official Name and Position | Rupinder K Chahal (PRESIDENT) |
| Authorized Official Contact | 2096331200 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
605 Standiford Ave Suite G Modesto CA 95350-1000 Ph: (209) 633-1200 | 605 Standiford Ave Suite G Modesto CA 95350-1000 Ph: (209) 633-1200 |
| NPI Number | 1447666078 |
|---|---|
| Provider Enumeration Date | 07/03/2014 |
| Last Update Date | 03/21/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1447666078 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 51599 (California) | Primary |
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