| Modesto Smiles Dentistry Dental Group | |
|
3601 Pelandale Ave Ste D-1 Modesto CA 95356-9808 | |
| (209) 245-0014 | |
| (209) 846-3026 |
| Full Name | Modesto Smiles Dentistry Dental Group |
|---|---|
| Speciality | Dentist |
| Location | 3601 Pelandale Ave Ste D-1, Modesto, California |
| Authorized Official Name and Position | Michael J Lopez (OWNER) |
| Authorized Official Contact | 2092450014 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Modesto Smiles Dentistry Dental Group Po Box 920050 Dallas TX 75392-0050 Ph: (714) 845-8500 | Modesto Smiles Dentistry Dental Group 3601 Pelandale Ave Ste D-1 Modesto CA 95356-9808 Ph: (209) 245-0014 |
| NPI Number | 1215438130 |
|---|---|
| Provider Enumeration Date | 02/26/2018 |
| Last Update Date | 02/04/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215438130 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | (* (Not Available)) | Primary |
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