| Ghozlan Dental Corp. | |
|
1745 W Kettleman Ln Suite B Lodi CA 95242-9287 | |
| (209) 367-0700 | |
| (209) 367-0717 |
| Full Name | Ghozlan Dental Corp. |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 1745 W Kettleman Ln, Lodi, California |
| Authorized Official Name and Position | Ayman Mahmoud Ghozlan (DENTIST) |
| Authorized Official Contact | 9163371077 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ghozlan Dental Corp. 1745 W Kettleman Ln Suite B Lodi CA 95242-9287 Ph: (209) 367-0700 | Ghozlan Dental Corp. 1745 W Kettleman Ln Suite B Lodi CA 95242-9287 Ph: (209) 367-0700 |
| NPI Number | 1447430624 |
|---|---|
| Provider Enumeration Date | 11/06/2007 |
| Last Update Date | 11/06/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1447430624 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 46060 (California) | Primary |
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