| |
460 E Shaw Ave Fresno CA 93710-7602 | |
(323) 203-2564 | |
Not Available |
Full Name | |
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Speciality | Dentist |
Location | 460 E Shaw Ave, Fresno, California |
Authorized Official Name and Position | Jerry Lee Lanier (PRESIDENT, OWNER) |
Authorized Official Contact | 3232032564 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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5449 Hollywood Blvd Ste A Los Angeles CA 90027-3454 Ph: (323) 203-2564 | 460 E Shaw Ave Fresno CA 93710-7602 Ph: (323) 203-2564 |
NPI Number | 1487307286 |
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Provider Enumeration Date | 02/01/2022 |
Last Update Date | 03/17/2022 |
Identifier | Type | State | Issuer |
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1487307286 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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122300000X | Dentist | (* (Not Available)) | Primary |
Raji Haddad D.d.s. Inc. Dba First Family Dental Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 310 W Shaw Ave, Fresno, CA 93704 Phone: 559-229-8200 | |
Kamal Dental Inc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 6319 N Fresno St Ste 101, Fresno, CA 93710 Phone: 559-438-6177 |