Healthcare Provider Details

I. General information

NPI: 1073737599
Provider Name (Legal Business Name): JOCELYN P MCPHERSON, DMD, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/13/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5141 W GOSHEN AVE
VISALIA CA
93291-8620
US

IV. Provider business mailing address

5141 W GOSHEN AVE
VISALIA CA
93291-8620
US

V. Phone/Fax

Practice location:
  • Phone: 559-734-7762
  • Fax: 559-734-7148
Mailing address:
  • Phone: 559-734-7762
  • Fax: 559-734-7148

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number50954
License Number StateCA

VIII. Authorized Official

Name: DR. JOCELYN P MCPHERSON
Title or Position: PRESIDENT
Credential: DMD
Phone: 559-734-7762