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525 S Fairmont Ave Ste F Lodi CA 95240-3860 | |
| (209) 369-1051 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 525 S Fairmont Ave Ste F, Lodi, California |
| Authorized Official Name and Position | Satvir Dhaliwal (PRESIDENT) |
| Authorized Official Contact | 2093691051 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
525 S Fairmont Ave Ste F Lodi CA 95240-3860 Ph: () - | 525 S Fairmont Ave Ste F Lodi CA 95240-3860 Ph: (209) 369-1051 |
| NPI Number | 1760973945 |
|---|---|
| Provider Enumeration Date | 05/23/2018 |
| Last Update Date | 05/23/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760973945 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 64258 (California) | Primary |
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