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General NPI Number Information
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NPI Number | 1679388037
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Entity Type | Organization
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Legal Business Name | PAULINE FAMILY DENTAL CARE
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Dates
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Enumeration Date | 02/11/2025
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Last Update Date | 02/12/2025
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Provider Practice Location Address
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Address Line | 5446 N PALM AVE STE 109
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City | FRESNO
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State | CA
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Zip | 93704-1945
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Country | US
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Telephone | 559-269-9831
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Fax | 559-721-5488
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Provider Business Mailing Address
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Address Line | 5446 N PALM AVE STE 109
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City | FRESNO
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State | CA
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Zip | 93704-1945
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Country | US
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Telephone | 559-269-9831
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Fax | 559-721-5488
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Authorized Official
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Title or Position | DENTIST/OWNER
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Name | NIMFA CONDE NADORES
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Credential | DMD
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Telephone | 559-269-9831
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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