| Edgar D. Roque, D.d.s.,inc | |
|
420 W. Shields Ave Fresno CA 93705-4107 | |
| (559) 412-4702 | |
| (559) 473-1475 |
| Full Name | Edgar D. Roque, D.d.s.,inc |
|---|---|
| Speciality | Dentist |
| Location | 420 W. Shields Ave, Fresno, California |
| Authorized Official Name and Position | Edgar Roque (DENTIST/PRESIDENT) |
| Authorized Official Contact | 5594124702 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Edgar D. Roque, D.d.s.,inc 420 W. Shields Ave Fresno CA 93705-4107 Ph: (559) 412-4702 | Edgar D. Roque, D.d.s.,inc 420 W. Shields Ave Fresno CA 93705-4107 Ph: (559) 412-4702 |
| NPI Number | 1699077487 |
|---|---|
| Provider Enumeration Date | 11/30/2010 |
| Last Update Date | 02/15/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699077487 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 55681 (California) | Primary |
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