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1404 Mitchell Rd Modesto CA 95351-4901 | |
| (209) 537-7878 | |
| (209) 537-7916 |
| Full Name | |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 1404 Mitchell Rd, Modesto, California |
| Authorized Official Name and Position | Minal S Desai (CEO / OWNER) |
| Authorized Official Contact | 2093802643 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
1404 Mitchell Rd Modesto CA 95351-4901 Ph: (209) 537-7878 | 1404 Mitchell Rd Modesto CA 95351-4901 Ph: (209) 537-7878 |
| NPI Number | 1992054308 |
|---|---|
| Provider Enumeration Date | 08/30/2012 |
| Last Update Date | 05/10/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992054308 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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