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2200 Mchenry Ave Ste B Modesto CA 95350-3255 | |
| (209) 526-9132 | |
| (209) 526-9131 |
| Full Name | |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 2200 Mchenry Ave Ste B, Modesto, California |
| Authorized Official Name and Position | Robert A Rosenbaum (PRESIDENT/ DENTIST) |
| Authorized Official Contact | 2095269132 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
2200 Mchenry Ave Ste B Modesto CA 95350-3255 Ph: (209) 526-9132 | 2200 Mchenry Ave Ste B Modesto CA 95350-3255 Ph: (209) 526-9132 |
| NPI Number | 1093749251 |
|---|---|
| Provider Enumeration Date | 07/11/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093749251 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 31100 (California) | Primary |
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