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1221 E Orangeburg Ave Ste 5and6 Modesto CA 95350-4654 | |
(916) 849-3174 | |
Not Available |
Full Name | |
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Speciality | Dentist - Pediatric Dentistry |
Location | 1221 E Orangeburg Ave Ste 5and6, Modesto, California |
Authorized Official Name and Position | Heather L Rich (MANAGER) |
Authorized Official Contact | 2095730879 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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9707 Blansfield Way Elk Grove CA 95757-4021 Ph: () - | 1221 E Orangeburg Ave Ste 5and6 Modesto CA 95350-4654 Ph: (916) 849-3174 |
NPI Number | 1457082208 |
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Provider Enumeration Date | 06/22/2022 |
Last Update Date | 06/13/2023 |
Identifier | Type | State | Issuer |
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1457082208 | NPI | - | NPPES |
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