Healthcare Provider Details

I. General information

NPI: 1285734129
Provider Name (Legal Business Name): BARBARA JEANNE CRETAN DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/22/2006
Last Update Date: 01/19/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

637 MERCED ST
NEWMAN CA
95360-1070
US

IV. Provider business mailing address

737 W CHILDS AVE
MERCED CA
95341-6805
US

V. Phone/Fax

Practice location:
  • Phone: 209-862-9449
  • Fax: 209-862-0274
Mailing address:
  • Phone: 209-383-1848
  • Fax: 209-383-1296

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number30780
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: