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General NPI Number Information
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NPI Number | 1194893826
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Entity Type | Individual
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Provider Name | WENDY QUIROZ D.D.S
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Gender | Female
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Dates
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Enumeration Date | 12/01/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 3077 W SHAW AVE
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City | FRESNO
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State | CA
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Zip | 93711-3220
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Country | US
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Telephone | 559-244-5501
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Fax | 559-244-5508
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Provider Business Mailing Address
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Address Line | 2780 SERENA AVE
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City | CLOVIS
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State | CA
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Zip | 93619-7400
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Country | US
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Telephone | 559-325-6302
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 54435
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License Number State | CA
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