| Keith Kanegawa, Dmd Professional Dental Corporation | |
|
600 S Fairmont Ave Lodi CA 95240-3835 | |
| (209) 369-3114 | |
| Not Available |
| Full Name | Keith Kanegawa, Dmd Professional Dental Corporation |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 600 S Fairmont Ave, Lodi, California |
| Authorized Official Name and Position | Keith Kanegawa (DENTIST) |
| Authorized Official Contact | 2093693114 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Keith Kanegawa, Dmd Professional Dental Corporation 600 S Fairmont Ave Lodi CA 95240-3835 Ph: (209) 369-3114 | Keith Kanegawa, Dmd Professional Dental Corporation 600 S Fairmont Ave Lodi CA 95240-3835 Ph: (209) 369-3114 |
| NPI Number | 1538181425 |
|---|---|
| Provider Enumeration Date | 07/23/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538181425 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 29318 (California) | Primary |
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