Healthcare Provider Details

I. General information

NPI: 1679735831
Provider Name (Legal Business Name): MARIE-HELENE MORIN D.M.D
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/30/2008
Last Update Date: 05/06/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1010 SHAW AVE, SUITE B
CLOVIS CA
93612
US

IV. Provider business mailing address

1010 SHAW AVE, SUITE B
CLOVIS CA
93612
US

V. Phone/Fax

Practice location:
  • Phone: 559-323-1776
  • Fax:
Mailing address:
  • Phone: 559-444-3155
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number56962
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: