| Shahram Shidmand Dds Inc | |
|
1211 N Del Mar Ave Fresno CA 93728-1958 | |
| (559) 497-8300 | |
| (559) 497-1501 |
| Full Name | Shahram Shidmand Dds Inc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 1211 N Del Mar Ave, Fresno, California |
| Authorized Official Name and Position | Sean Shidmand (PRESIDENT) |
| Authorized Official Contact | 5594798300 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Shahram Shidmand Dds Inc 1211 N Del Mar Ave Fresno CA 93728-1958 Ph: (559) 497-8300 | Shahram Shidmand Dds Inc 1211 N Del Mar Ave Fresno CA 93728-1958 Ph: (559) 497-8300 |
| NPI Number | 1073720504 |
|---|---|
| Provider Enumeration Date | 05/16/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073720504 | NPI | - | NPPES |
| G92364-01 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 48018 (California) | Primary |
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