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333 San Carlos Wy Ste A Stockton CA 95207-2037 | |
| (209) 536-8333 | |
| (209) 645-1002 |
| Full Name | |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 333 San Carlos Wy, Stockton, California |
| Authorized Official Name and Position | Ahmad Momani (CEO) |
| Authorized Official Contact | 2095273990 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
3025 Mchenry Ave Ste N Modesto CA 95350-1449 Ph: (209) 337-4777 | 333 San Carlos Wy Ste A Stockton CA 95207-2037 Ph: (209) 536-8333 |
| NPI Number | 1932733029 |
|---|---|
| Provider Enumeration Date | 02/27/2020 |
| Last Update Date | 02/27/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932733029 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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