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2937 Veneman Ave Ste A201 Modesto CA 95356-0681 | |
(209) 524-5044 | |
(209) 524-5064 |
Full Name | |
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Speciality | Dentist - General Practice |
Location | 2937 Veneman Ave Ste A201, Modesto, California |
Authorized Official Name and Position | Ray Richard Rodig (OWNER PRESIDENT) |
Authorized Official Contact | 2095245044 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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2937 Veneman Ave Ste A201 Modesto CA 95356-0681 Ph: (209) 524-5044 | 2937 Veneman Ave Ste A201 Modesto CA 95356-0681 Ph: (209) 524-5044 |
NPI Number | 1396963633 |
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Provider Enumeration Date | 04/23/2007 |
Last Update Date | 08/22/2020 |
Identifier | Type | State | Issuer |
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1396963633 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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1223G0001X | Dentist - General Practice | 31851 (California) | Primary |
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