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NPI 1831910983

NPI 1831910983 : MARY INMAN DDS : VISALIA, CA

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General NPI Number Information
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    NPI Number           |    1831910983
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    Entity Type          |    Individual 
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    Provider Name        |    MARY INMAN DDS
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    10/22/2024
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    Last Update Date     |    10/22/2024
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Provider Practice Location Address
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    Address Line         |    4129 S MOONEY BLVD 
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    City                 |    VISALIA
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    State                |    CA
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    Zip                  |    93277-9147
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    Country              |    US
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    Telephone            |    559-732-1953
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    2101 N LINDSAY CT 
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    City                 |    VISALIA
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    State                |    CA
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    Zip                  |    93291-8492
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    Country              |    US
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    Telephone            |    314-302-4226
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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        |    122300000X
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    Taxonomy Name        |    Dentist
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    License Number       |    110864
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    License Number State |    CA
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