Healthcare Provider Details

I. General information

NPI: 1821017997
Provider Name (Legal Business Name): GRABE,SCHAPANSKY,MOSS,JULIAN&ASSELIN
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/19/2006
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6099 N 1ST ST SUITE 104
FRESNO CA
93710-5462
US

IV. Provider business mailing address

6099 N 1ST ST SUITE 104
FRESNO CA
93710-5462
US

V. Phone/Fax

Practice location:
  • Phone: 559-431-1400
  • Fax: 559-431-1590
Mailing address:
  • Phone: 559-431-1400
  • Fax: 559-431-1590

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number StateCA

VIII. Authorized Official

Name: MRS. ROSEMARY PFEIFFER
Title or Position: OFFICE MANAGER
Credential:
Phone: 559-431-1400