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General NPI Number Information
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NPI Number | 1306521851
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Entity Type | Organization
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Legal Business Name | ROCIO ESTREMADOYRO DENTAL CORPORATION
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Dates
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Enumeration Date | 06/21/2023
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Last Update Date | 06/21/2023
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Provider Practice Location Address
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Address Line | 6425 N PALM AVE STE 105
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City | FRESNO
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State | CA
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Zip | 93704-1084
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Country | US
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Telephone | 559-439-6425
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Fax |
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Provider Business Mailing Address
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Address Line | 3244 QUINCY AVE
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City | CLOVIS
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State | CA
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Zip | 93619-8120
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Country | US
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Telephone | 818-510-6458
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Fax |
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Authorized Official
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Title or Position | PRACTICE MANAGER
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Name | RACHELLE L CARTWRIGHT
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Credential |
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Telephone | 360-949-2949
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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 |
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License Number State |
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