Healthcare Provider Details

I. General information

NPI: 1811277759
Provider Name (Legal Business Name): NECDET OZDER DENTAL PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/24/2011
Last Update Date: 07/23/2020
Certification Date: 07/23/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7015 N CHESTNUT AVE STE 104
FRESNO CA
93720-0349
US

IV. Provider business mailing address

7015 N CHESTNUT AVE STE 104
FRESNO CA
93720-0349
US

V. Phone/Fax

Practice location:
  • Phone: 559-475-0357
  • Fax: 559-475-0389
Mailing address:
  • Phone: 559-475-0357
  • Fax: 559-475-0389

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number53844
License Number StateCA

VIII. Authorized Official

Name: DR. NECDET OZDER
Title or Position: PRESIDENT
Credential: D.D.S.
Phone: 661-202-0454