| Manjeet Samra Dental Corporation | |
|
1700 Mchenry Ave Ste 16b Modesto CA 95350-4319 | |
| (209) 923-3013 | |
| Not Available |
| Full Name | Manjeet Samra Dental Corporation |
|---|---|
| Speciality | Dentist - Orthodontics And Dentofacial Orthopedics |
| Location | 1700 Mchenry Ave Ste 16b, Modesto, California |
| Authorized Official Name and Position | Manjeet Samra (OWNER) |
| Authorized Official Contact | 2099233013 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Manjeet Samra Dental Corporation 1110 W Robinhood Dr Stockton CA 95207-5606 Ph: () - | Manjeet Samra Dental Corporation 1700 Mchenry Ave Ste 16b Modesto CA 95350-4319 Ph: (209) 923-3013 |
| NPI Number | 1144832221 |
|---|---|
| Provider Enumeration Date | 08/19/2020 |
| Last Update Date | 08/19/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144832221 | NPI | - | NPPES |
| 1 | Other | CA | LOCATION |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223X0400X | Dentist - Orthodontics And Dentofacial Orthopedics | (* (Not Available)) | Primary |
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