| Bakersfield Orthodontic Dental Group | |
|
515 W Columbus St Ste Ab Bakersfield CA 93301-5846 | |
| (661) 323-5910 | |
| Not Available |
| Full Name | Bakersfield Orthodontic Dental Group |
|---|---|
| Speciality | Dentist - Orthodontics And Dentofacial Orthopedics |
| Location | 515 W Columbus St Ste Ab, Bakersfield, California |
| Authorized Official Name and Position | Guy W Mendivil (OWNER) |
| Authorized Official Contact | 6613235910 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Bakersfield Orthodontic Dental Group 515 W Columbus St Ste Ab Bakersfield CA 93301-5846 Ph: (661) 323-5910 | Bakersfield Orthodontic Dental Group 515 W Columbus St Ste Ab Bakersfield CA 93301-5846 Ph: (661) 323-5910 |
| NPI Number | 1255477592 |
|---|---|
| Provider Enumeration Date | 01/30/2007 |
| Last Update Date | 06/22/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255477592 | NPI | - | NPPES |
| G9391401 | Other | CA | DENTI-CAL |
| 170062 | Other | CA | CGP |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223X0400X | Dentist - Orthodontics And Dentofacial Orthopedics | D29737 (California) | Primary |
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