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1801 Tully Road Suite B Modesto CA 95350 | |
| (209) 343-3500 | |
| (209) 527-1971 |
| Full Name | |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 1801 Tully Road, Modesto, California |
| Authorized Official Name and Position | Corey Robert Acree (PRESIDENT) |
| Authorized Official Contact | 2095290674 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
1801 Tully Road Suite B Modesto CA 95350 Ph: (209) 343-3500 | 1801 Tully Road Suite B Modesto CA 95350 Ph: (209) 343-3500 |
| NPI Number | 1427021757 |
|---|---|
| Provider Enumeration Date | 02/08/2006 |
| Last Update Date | 08/05/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1427021757 | NPI | - | NPPES |
| 20789 | Other | CA | DENTAL LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 48870 (California) | Secondary |
| 1223P0221X | Dentist - Pediatric Dentistry | 48880 (California) | Primary |
Roger B. Wei, Dds, A Professional Corporation Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 2225 Plaza Pkwy Ste C12, Modesto, CA 95350 Phone: 209-491-3620 | |
A S Gill Dental Corp Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1518 Coffee Rd Ste B, Modesto, CA 95355 Phone: 209-809-0123 | |
Stephanie Diego Dental Corporation Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1130 Coffee Rd Ste 8a, Modesto, CA 95355 Phone: 209-566-1990 | |