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General NPI Number Information
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NPI Number | 1598143208
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Entity Type | Individual
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Provider Name | VICTORIA GEREN DDS
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Gender | Female
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Dates
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Enumeration Date | 05/13/2015
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Last Update Date | 10/14/2020
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Provider Practice Location Address
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Address Line | 323 E BULLARD AVE STE 104
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City | FRESNO
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State | CA
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Zip | 93710-8620
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Country | US
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Telephone | 559-439-9990
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Fax | 559-439-9996
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Provider Business Mailing Address
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Address Line | 1900 SHAW AVE STE 102
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City | CLOVIS
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State | CA
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Zip | 93611-4209
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Country | US
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Telephone | 559-439-9990
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Fax | 559-321-8831
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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 | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 64459
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License Number State | CA
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