| Nicholas Poblete, D.d.s., Inc. | |
|
1316 Coffee Rd Bldg. C Modesto CA 95355-3191 | |
| (209) 521-6822 | |
| (209) 521-0466 |
| Full Name | Nicholas Poblete, D.d.s., Inc. |
|---|---|
| Speciality | Dentist |
| Location | 1316 Coffee Rd, Modesto, California |
| Authorized Official Name and Position | Nicholas Ellis Poblete (DENTIST) |
| Authorized Official Contact | 2095216822 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Nicholas Poblete, D.d.s., Inc. 1316 Coffee Rd Bldg. C Modesto CA 95355-3191 Ph: (209) 521-6822 | Nicholas Poblete, D.d.s., Inc. 1316 Coffee Rd Bldg. C Modesto CA 95355-3191 Ph: (209) 521-6822 |
| NPI Number | 1336340165 |
|---|---|
| Provider Enumeration Date | 05/30/2007 |
| Last Update Date | 09/07/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336340165 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 49190 (California) | Primary |
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