| Modesto Modern Dentistry Dental Group | |
|
2103 Mchenry Avenue, Suite C Modesto CA 95350 | |
| (209) 435-9550 | |
| (209) 390-1563 |
| Full Name | Modesto Modern Dentistry Dental Group |
|---|---|
| Speciality | Dentist |
| Location | 2103 Mchenry Avenue, Suite C, Modesto, California |
| Authorized Official Name and Position | Micahel Lopez (OWNER DOCTOR) |
| Authorized Official Contact | 2094359550 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Modesto Modern Dentistry Dental Group 17000 Red Hill Avenue Irvine CA 92614 Ph: (714) 845-8656 | Modesto Modern Dentistry Dental Group 2103 Mchenry Avenue, Suite C Modesto CA 95350 Ph: (209) 435-9550 |
| NPI Number | 1821461104 |
|---|---|
| Provider Enumeration Date | 11/09/2015 |
| Last Update Date | 11/09/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821461104 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | (* (Not Available)) | Primary |
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