| Centennial Dental Clinic | |
|
201 China Grade Loop Bakersfield CA 93308-1707 | |
| (661) 393-4333 | |
| (661) 393-4343 |
| Full Name | Centennial Dental Clinic |
|---|---|
| Speciality | Dentist |
| Location | 201 China Grade Loop, Bakersfield, California |
| Authorized Official Name and Position | Wasfi F Salama (OWNER) |
| Authorized Official Contact | 6613934333 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Centennial Dental Clinic 201 China Grade Loop Bakersfield CA 93308-1707 Ph: (661) 393-4333 | Centennial Dental Clinic 201 China Grade Loop Bakersfield CA 93308-1707 Ph: (661) 393-4333 |
| NPI Number | 1093075970 |
|---|---|
| Provider Enumeration Date | 05/24/2012 |
| Last Update Date | 09/29/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093075970 | NPI | - | NPPES |
| G94115-02 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | (California) | Primary |
| 1223E0200X | Dentist - Endodontics | (California) | Secondary |
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