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1658 N Blackstone Ave Fresno CA 93703-2908 | |
| (559) 673-9000 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 1658 N Blackstone Ave, Fresno, California |
| Authorized Official Name and Position | Brenda Judith Salazar (PRESIDENT) |
| Authorized Official Contact | 5596739000 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
1658 N Blackstone Ave Fresno CA 93703-2908 Ph: (559) 673-9000 | 1658 N Blackstone Ave Fresno CA 93703-2908 Ph: (559) 673-9000 |
| NPI Number | 1396191508 |
|---|---|
| Provider Enumeration Date | 05/05/2016 |
| Last Update Date | 05/05/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396191508 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 57014 (California) | Primary |
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