| Full Name | |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 1120 Olivewood Dr, Merced, California |
| Authorized Official Name and Position | Raedh S Alhwadi (MANAGING DOCTOR) |
| Authorized Official Contact | 2097250905 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
1120 Olivewood Dr Merced CA 95348 Ph: (209) 725-0905 | 1120 Olivewood Dr Merced CA 95348 Ph: (209) 725-0905 |
| NPI Number | 1679666895 |
|---|---|
| Provider Enumeration Date | 10/02/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679666895 | NPI | - | NPPES |
| G9278101 | Other | CA | DENTI CAL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 51080 (California) | Primary |
| 1223G0001X | Dentist - General Practice | 48217 (California) | Primary |
Ken Chan Dds Inc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1176 Olivewood Dr, Merced, CA 95348 Phone: 209-600-7123 Fax: 209-349-8077 | |
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