Healthcare Provider Details

I. General information

NPI: 1891369864
Provider Name (Legal Business Name): SYED HYDER DDS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/14/2021
Last Update Date: 05/14/2021
Certification Date: 05/14/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1207 14TH ST
MODESTO CA
95354-1005
US

IV. Provider business mailing address

1207 14TH ST
MODESTO CA
95354-1005
US

V. Phone/Fax

Practice location:
  • Phone: 209-715-0463
  • Fax:
Mailing address:
  • Phone: 209-715-0463
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. SYED T HYDER
Title or Position: DR
Credential:
Phone: 209-715-0463