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General NPI Number Information
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NPI Number | 1659618148
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Entity Type | Organization
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Legal Business Name | SHAMLIAN DENTISTRY INC.
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Dates
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Enumeration Date | 01/03/2013
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Last Update Date | 01/03/2013
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Provider Practice Location Address
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Address Line | 7077 N WEST AVE STE 107
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City | FRESNO
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State | CA
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Zip | 93711-0669
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Country | US
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Telephone | 559-438-4646
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Fax | 559-438-4652
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Provider Business Mailing Address
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Address Line | 7077 N WEST AVE STE 107
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City | FRESNO
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State | CA
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Zip | 93711-0669
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Country | US
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Telephone | 559-438-4646
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Fax | 559-438-4652
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Authorized Official
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Title or Position | DENTIST
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Name | DR. DENNIS EDWARD SHAMLINA
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Credential | D.D.S., M.A.G.D.
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Telephone | 559-438-4642
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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 | 28812
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License Number State | CA
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