| Otto R. Alonzo, D.d.s., Inc. | |
|
145 Shaw Ave Suite B2 Clovis CA 93612-3841 | |
| (559) 325-2175 | |
| (559) 325-2227 |
| Full Name | Otto R. Alonzo, D.d.s., Inc. |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 145 Shaw Ave, Clovis, California |
| Authorized Official Name and Position | Otto Raul Alonzo (PRESIDENT) |
| Authorized Official Contact | 5597761829 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Otto R. Alonzo, D.d.s., Inc. 145 Shaw Ave Suite B2 Clovis CA 93612-3841 Ph: (559) 325-2175 | Otto R. Alonzo, D.d.s., Inc. 145 Shaw Ave Suite B2 Clovis CA 93612-3841 Ph: (559) 325-2175 |
| NPI Number | 1639443575 |
|---|---|
| Provider Enumeration Date | 02/23/2012 |
| Last Update Date | 02/23/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639443575 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 50719 (California) | Primary |
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