| Divine Dental Studio | |
|
1420 Mitchell Rd Modesto CA 95351-4901 | |
| (209) 207-7777 | |
| Not Available |
| Full Name | Divine Dental Studio |
|---|---|
| Speciality | Dentist |
| Location | 1420 Mitchell Rd, Modesto, California |
| Authorized Official Name and Position | Lomesh Jayantilal Popat (MANAGING MEMBER) |
| Authorized Official Contact | 2092077777 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Divine Dental Studio 1420 Mitchell Rd Modesto CA 95351-4901 Ph: (209) 207-7777 | Divine Dental Studio 1420 Mitchell Rd Modesto CA 95351-4901 Ph: (209) 207-7777 |
| NPI Number | 1659045615 |
|---|---|
| Provider Enumeration Date | 08/04/2021 |
| Last Update Date | 06/24/2024 |
| Medicare PECOS PAC ID | 0547622029 |
|---|---|
| Medicare Enrollment ID | O20230815003638 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659045615 | NPI | - | NPPES |
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