| |
201 China Grade Loop Bakersfield CA 93308-1707 | |
(661) 393-4333 | |
(661) 393-4343 |
Full Name | |
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Speciality | Dentist |
Location | 201 China Grade Loop, Bakersfield, California |
Authorized Official Name and Position | Wasfi F Salama (OWNER) |
Authorized Official Contact | 6613934333 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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201 China Grade Loop Bakersfield CA 93308-1707 Ph: (661) 393-4333 | 201 China Grade Loop Bakersfield CA 93308-1707 Ph: (661) 393-4333 |
NPI Number | 1093075970 |
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Provider Enumeration Date | 05/24/2012 |
Last Update Date | 09/29/2015 |
Identifier | Type | State | Issuer |
---|---|---|---|
1093075970 | NPI | - | NPPES |
G94115-02 | Medicaid | CA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
122300000X | Dentist | (California) | Primary |
1223E0200X | Dentist - Endodontics | (California) | Secondary |
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