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243 N Farmersville Blvd Farmersville CA 93223-1570 | |
(559) 747-5200 | |
(559) 747-5203 |
Full Name | |
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Speciality | Dentist - General Practice |
Location | 243 N Farmersville Blvd, Farmersville, California |
Authorized Official Name and Position | Reza Khazaeizadeh (PRESIDENT) |
Authorized Official Contact | 5597475200 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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243 N Farmersville Blvd Farmersville CA 93223-1570 Ph: (559) 747-5200 | 243 N Farmersville Blvd Farmersville CA 93223-1570 Ph: (559) 747-5200 |
NPI Number | 1285981159 |
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Provider Enumeration Date | 08/10/2012 |
Last Update Date | 08/10/2012 |
Identifier | Type | State | Issuer |
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1285981159 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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1223G0001X | Dentist - General Practice | 57020 (California) | Primary |