MEDICARE: N. OZDER DENTAL PRACTICE INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QD0000X	Dental Clinic/Center

General Provider Information

NPI Number	:	1538641428
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	N. OZDER DENTAL PRACTICE INC

Provider Business Mailing Address
First Line	:	1530 E GOLDEN VALLEY WAY
Second Line	:
City	:	FRESNO
State	:	CA
Zip	:	93730-3587
Country	:	US
Telephone Number	:	661-202-0454
Fax Number	:	559-475-0389

Provider Business Practice Location Address
First Line	:	1125 E 17TH ST STE W233
Second Line	:
City	:	SANTA ANA
State	:	CA
Zip	:	92701-2228
Country	:	US
Telephone Number	:	714-957-6030
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	NECDET OZDER
Credential	:	DDS
Telephone Number	:	661-202-0454

Provider Enumeration Date	:	09/06/2018
Last Update Date	:	07/11/2022

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