| |
9550 Brimhall Rd Ste B Bakersfield CA 93312-2231 | |
(661) 395-0698 | |
(661) 395-0698 |
Full Name | |
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Speciality | Dentist |
Location | 9550 Brimhall Rd Ste B, Bakersfield, California |
Authorized Official Name and Position | Michael Murry Thurman (OWNER) |
Authorized Official Contact | 6613950698 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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9550 Brimhall Rd Ste B Bakersfield CA 93312-2231 Ph: (661) 395-0698 | 9550 Brimhall Rd Ste B Bakersfield CA 93312-2231 Ph: (661) 395-0698 |
NPI Number | 1255799508 |
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Provider Enumeration Date | 02/02/2016 |
Last Update Date | 02/02/2016 |
Medicare PECOS PAC ID | 8628482627 |
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Medicare Enrollment ID | O20210203001457 |
Identifier | Type | State | Issuer |
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1255799508 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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1223X0400X | Dentist - Orthodontics And Dentofacial Orthopedics | 59041 (California) | Primary |
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