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General NPI Number Information
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NPI Number | 1073103032
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Entity Type | Organization
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Legal Business Name | J E MOLINA DDS INC.
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Dates
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Enumeration Date | 01/24/2021
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Last Update Date | 01/24/2021
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Provider Practice Location Address
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Address Line | 1406 E ALLUVIAL AVE # 102
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City | FRESNO
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State | CA
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Zip | 93720-2606
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Country | US
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Telephone | 559-432-3456
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Fax | 559-369-6104
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Provider Business Mailing Address
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Address Line | 1406 E ALLUVIAL AVE # 102
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City | FRESNO
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State | CA
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Zip | 93720-2606
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Country | US
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Telephone | 559-432-3456
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Fax | 559-369-6104
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Authorized Official
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Title or Position | GENERAL DENTIST
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Name | DR. JOSE EDUARDO MOLINA
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Credential | DDS
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Telephone | 559-432-3456
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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