Custom Dental | |
3409 Calloway Dr Unit 402 Bakersfield CA 93312-2517 | |
(661) 387-6577 | |
Not Available |
Full Name | Custom Dental |
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Speciality | Dentist - General Practice |
Location | 3409 Calloway Dr Unit 402, Bakersfield, California |
Authorized Official Name and Position | Benjamin J. Lin (OWNER/DENTIST) |
Authorized Official Contact | 6613876577 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Custom Dental 3409 Calloway Dr Unit 402 Bakersfield CA 93312-2517 Ph: (661) 387-6577 | Custom Dental 3409 Calloway Dr Unit 402 Bakersfield CA 93312-2517 Ph: (661) 387-6577 |
NPI Number | 1942498746 |
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Provider Enumeration Date | 10/07/2007 |
Last Update Date | 02/21/2012 |
Identifier | Type | State | Issuer |
---|---|---|---|
1942498746 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1223G0001X | Dentist - General Practice | 54173 (California) | Primary |
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