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NPI Code Detail

MEDICARE: MID VALLEY DENTAL CARE

MEDICARE: MID VALLEY DENTAL CARE
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
11223G0001XGeneral Practice Dentistry46158CA

General Provider Information

NPI Number : 1669598975
Entity Type Code : Organization
Provider Name (Legal Business Name) : MID VALLEY DENTAL CARE
Provider Business Mailing Address
First Line : 4035 N FRESNO ST STE 105
Second Line :
City : FRESNO
State : CA
Zip : 93726-4041
Country : US
Telephone Number : 559-228-9300
Fax Number : 559-228-9302
Provider Business Practice Location Address
First Line : 4035 N FRESNO ST STE 105
Second Line :
City : FRESNO
State : CA
Zip : 93726-4041
Country : US
Telephone Number : 559-228-9300
Fax Number : 559-228-9302
Authorized Official
Title or Position : DENTIST
Name : DR. REY QUIJANO YULIONGSIU
Credential : D.D.S.
Telephone Number : 559-228-9300
Provider Enumeration Date : 03/21/2007
Last Update Date : 08/22/2020

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Directions to “MID VALLEY DENTAL CARE ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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