| Dental Group Of Clovis | |
|
200 W Shaw Ave Suite 110 Clovis CA 93612-3684 | |
| (559) 325-6161 | |
| (559) 325-6166 |
| Full Name | Dental Group Of Clovis |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 200 W Shaw Ave, Clovis, California |
| Authorized Official Name and Position | Farid Pakravan (OWNER) |
| Authorized Official Contact | 5593256161 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dental Group Of Clovis 200 W Shaw Ave Suite 110 Clovis CA 93612-3684 Ph: (559) 325-6161 | Dental Group Of Clovis 200 W Shaw Ave Suite 110 Clovis CA 93612-3684 Ph: (559) 325-6161 |
| NPI Number | 1508089889 |
|---|---|
| Provider Enumeration Date | 04/11/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508089889 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 39862 (California) | Primary |
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