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General NPI Number Information
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NPI Number | 1912604950
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Entity Type | Organization
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Legal Business Name | CELESTE DENTAL INC.
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Dates
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Enumeration Date | 02/09/2023
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Last Update Date | 02/09/2023
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Provider Practice Location Address
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Address Line | 1308 CELESTE DR STE 1
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City | MODESTO
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State | CA
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Zip | 95355-2402
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Country | US
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Telephone | 209-765-6929
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Fax |
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Provider Business Mailing Address
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Address Line | 1601 MCHENRY VILLAGE WAY STE 1
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City | MODESTO
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State | CA
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Zip | 95350-4338
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Country | US
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Telephone | 209-765-6929
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Fax |
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Authorized Official
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Title or Position | DENTIST
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Name | DR. RAMINDER K PANDHER
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Credential | DMD
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Telephone | 209-765-6929
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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 |
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License Number State |
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