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General NPI Number Information
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NPI Number | 1992054308
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Entity Type | Organization
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Legal Business Name | SATYEN DESAI DENTAL CORPORATION
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Dates
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Enumeration Date | 08/30/2012
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Last Update Date | 05/10/2024
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Provider Practice Location Address
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Address Line | 1404 MITCHELL RD
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City | MODESTO
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State | CA
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Zip | 95351-4901
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Country | US
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Telephone | 209-537-7878
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Fax | 209-537-7916
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Provider Business Mailing Address
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Address Line | 1404 MITCHELL RD
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City | MODESTO
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State | CA
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Zip | 95351-4901
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Country | US
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Telephone | 209-537-7878
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Fax | 209-537-7916
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Authorized Official
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Title or Position | CEO / OWNER
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Name | DR. MINAL S DESAI
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Credential | DDS
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Telephone | 209-380-2643
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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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