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General NPI Number Information
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NPI Number | 1154199404
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Entity Type | Organization
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Legal Business Name | CENTRAL VALLEY DENTAL IMPLANT & ORAL SURGERY INSTITUTE II
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Dates
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Enumeration Date | 12/15/2023
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Last Update Date | 12/15/2023
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Provider Practice Location Address
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Address Line | 1116 N CHINOWTH ST
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City | VISALIA
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State | CA
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Zip | 93291-7896
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Country | US
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Telephone | 559-732-7946
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Fax | 559-732-9621
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Provider Business Mailing Address
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Address Line | PO BOX 7239
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City | VISALIA
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State | CA
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Zip | 93290-7239
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Country | US
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Telephone | 559-732-7946
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Fax | 559-732-9621
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Authorized Official
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Title or Position | PARTNER
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Name | DR. SPENCER JAMES ANDERSON
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Credential | DDS
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Telephone | 559-732-7946
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number |
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License Number State |
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