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General NPI Number Information
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NPI Number | 1023924909
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Entity Type | Organization
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Legal Business Name | LIVING WATER DENTAL CLINIC
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Dates
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Enumeration Date | 08/20/2026
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Last Update Date | 08/20/2026
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Provider Practice Location Address
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Address Line | 233 S MIRAGE AVE
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City | LINDSAY
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State | CA
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Zip | 93247-2543
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Country | US
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Telephone | 559-562-5969
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Fax |
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Provider Business Mailing Address
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Address Line | 222 W HENDERSON AVE
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City | PORTERVILLE
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State | CA
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Zip | 93257-1731
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Country | US
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Telephone | 559-784-5483
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Fax | 559-789-9828
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Authorized Official
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Title or Position | CEO
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Name | ERICK MADRIGAL
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Credential | MD
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Telephone | 559-784-5483
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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