| Lodi Dental Group | |
|
531 Kettleman Ln Lodi CA 95240 | |
| (209) 366-1850 | |
| (209) 333-1879 |
| Full Name | Lodi Dental Group |
|---|---|
| Speciality | Dentist |
| Location | 531 Kettleman Ln, Lodi, California |
| Authorized Official Name and Position | Sean Hakimi (OWNER) |
| Authorized Official Contact | 6612553130 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lodi Dental Group Po Box 55368 Valencia CA 91385-0368 Ph: (661) 255-3130 | Lodi Dental Group 531 Kettleman Ln Lodi CA 95240 Ph: (209) 366-1850 |
| NPI Number | 1740470178 |
|---|---|
| Provider Enumeration Date | 08/01/2007 |
| Last Update Date | 08/01/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740470178 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 39643 (California) | Primary |
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