| Tracy Smiles Modern Dentistry | |
|
2600 S Tracy Blvd Suite 170 Tracy CA 95376-9103 | |
| (209) 836-5441 | |
| (209) 836-5453 |
| Full Name | Tracy Smiles Modern Dentistry |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 2600 S Tracy Blvd, Tracy, California |
| Authorized Official Name and Position | Khaled Entabi (OWNER DOCTOR) |
| Authorized Official Contact | 2098365441 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Tracy Smiles Modern Dentistry 17000 Red Hill Ave Irvine CA 92614-5626 Ph: (714) 845-8890 | Tracy Smiles Modern Dentistry 2600 S Tracy Blvd Suite 170 Tracy CA 95376-9103 Ph: (209) 836-5441 |
| NPI Number | 1326359944 |
|---|---|
| Provider Enumeration Date | 06/29/2010 |
| Last Update Date | 08/22/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326359944 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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