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2377 W Cleveland Ave Ste 107 Madera CA 93637-8754 | |
| (559) 660-5588 | |
| (559) 660-5412 |
| Full Name | |
|---|---|
| Speciality | Dentist - Orthodontics And Dentofacial Orthopedics |
| Location | 2377 W Cleveland Ave Ste 107, Madera, California |
| Authorized Official Name and Position | Angie Buruca (CREDENTIALING COORDINATOR) |
| Authorized Official Contact | 5598371066 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
427 W Nees Ave Ste 101 Clovis CA 93611-4434 Ph: (559) 660-5588 | 2377 W Cleveland Ave Ste 107 Madera CA 93637-8754 Ph: (559) 660-5588 |
| NPI Number | 1861924359 |
|---|---|
| Provider Enumeration Date | 04/03/2017 |
| Last Update Date | 06/08/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861924359 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223X0400X | Dentist - Orthodontics And Dentofacial Orthopedics | 50037 (California) | Primary |
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