| Modern Dental And Implants | |
|
601 W Kettleman Ln Lodi CA 95240-6006 | |
| (209) 366-1850 | |
| Not Available |
| Full Name | Modern Dental And Implants |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 601 W Kettleman Ln, Lodi, California |
| Authorized Official Name and Position | Devan Dalla (CEO) |
| Authorized Official Contact | 6464276519 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Modern Dental And Implants 601 W Kettleman Ln Lodi CA 95240-6006 Ph: (209) 366-1850 | Modern Dental And Implants 601 W Kettleman Ln Lodi CA 95240-6006 Ph: (209) 366-1850 |
| NPI Number | 1609403021 |
|---|---|
| Provider Enumeration Date | 03/25/2020 |
| Last Update Date | 07/01/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609403021 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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