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General NPI Number Information
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NPI Number | 1740374453
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Entity Type | Individual
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Provider Name | DR. THOMAS LEE WINEGARDEN
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Gender | Male
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Dates
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Enumeration Date | 10/03/2006
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Last Update Date | 11/23/2015
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Provider Practice Location Address
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Address Line | 6767 N FRESNO ST STE 200
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City | FRESNO
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State | CA
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Zip | 93710-3709
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Country | US
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Telephone | 559-447-3020
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Fax | 559-447-3025
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Provider Business Mailing Address
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Address Line | 21281 LOPER VALLEY RD
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City | PRATHER
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State | CA
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Zip | 93651-9616
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Country | US
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Telephone | 559-285-2510
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 29905
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License Number State | CA
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