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13029 Stockdale Hwy Suite 100 Bakersfield CA 93314-9589 | |
| (661) 829-7905 | |
| (661) 829-7907 |
| Full Name | |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 13029 Stockdale Hwy, Bakersfield, California |
| Authorized Official Name and Position | Padmaja K Mutyala (DENTIST/OWNER) |
| Authorized Official Contact | 6618297905 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
13029 Stockdale Hwy Suite 100 Bakersfield CA 93314-9589 Ph: () - | 13029 Stockdale Hwy Suite 100 Bakersfield CA 93314-9589 Ph: (661) 829-7905 |
| NPI Number | 1740670066 |
|---|---|
| Provider Enumeration Date | 01/24/2015 |
| Last Update Date | 01/26/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740670066 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 54081 (California) | Primary |
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