Roland I. Young, Dds, Inc. | |
1316 Coffee Rd Ste E14 Modesto CA 95355-3191 | |
(209) 522-9963 | |
(209) 522-5184 |
Full Name | Roland I. Young, Dds, Inc. |
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Speciality | Dentist - Oral And Maxillofacial Surgery |
Location | 1316 Coffee Rd Ste E14, Modesto, California |
Authorized Official Name and Position | Roland Ian Young (OWNER/DOCTOR) |
Authorized Official Contact | 2095229963 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Roland I. Young, Dds, Inc. 1316 Coffee Rd Ste E14 Modesto CA 95355-3191 Ph: (209) 522-9963 | Roland I. Young, Dds, Inc. 1316 Coffee Rd Ste E14 Modesto CA 95355-3191 Ph: (209) 522-9963 |
NPI Number | 1710134085 |
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Provider Enumeration Date | 08/19/2008 |
Last Update Date | 08/19/2008 |
Identifier | Type | State | Issuer |
---|---|---|---|
1710134085 | NPI | - | NPPES |
B29538-01 | Medicaid | CA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1223S0112X | Dentist - Oral And Maxillofacial Surgery | 29538 (California) | Primary |
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